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Blue Care Network
BlueCaid
The BlueCaid prescription drug program (PDF) identifies the basic terms of coverage for BlueCaid members. When prescribing medications for BlueCaid members, please refer to the BlueCaid Preferred Drug List (PDF). Note that HIV/AIDS and most psychotropic drugs are covered by the Michigan Department of Community Health and are not payable through BlueCaid. Refer to the complete list of these drugs: Michigan Department of Community Health - Health Plan Carve-Out (PDF).
BlueCaid members can have their prescription filled at more than 2,000 retail pharmacies throughout Michigan. Walgreens® Specialty Pharmacy, LLC handles mail-order prescriptions for specialty drugs (PDF). Members can also fill their specialty drug prescriptions at a University of Michigan Health System Pharmacy, or from a BlueCaid-affiliated retail pharmacy.
If a medication requires step-therapy or prior authorization, you can request coverage for your BlueCaid patient based on medical necessity. Generally, BlueCaid will only approve your request for authorization if the alternative drugs on the BlueCaid Preferred Drug List (PDF) would not be effective for the member or would cause the member to have adverse medical effects. Requests for coverage for drugs provided through the Michigan Department of Community Health should be directed to First Health at 1-877-624-5204.
There are two ways to request coverage:
- Contact the BCN Clinical Pharmacy Help Desk at 1-800-437-3803 to initiate a prior authorization request.
- Complete the BlueCaid Medication Request Form located on web-DENIS > BCN Provider Publications and Resources > BlueCaid. Fax completed forms to the Clinical Pharmacy Help Desk at 1-877-442-3778. If you need to send an attachment, please fax the attachment with the form.
