If you go to a pharmacy to fill your prescription, it's most likely billed to your pharmacy coverage.

You can find out if a medication needs prior authorization by logging in to your account at bcbsm.com. You’ll need to know the name of the medication, the dosage and how often you’ll be taking it.

  1. After you've logged in, hover over My Coverage in the blue bar at the top of the page.
  2. Select Prescription Drugs from the drop down.
  3. Click the link price a drug and view additional benefit requirements. 
  4. Enter the name of the drug and follow the instructions.
  5. You'll get a coverage alert if the medication needs prior authorization. Your doctor can ask for a prior authorization by calling 1-800-437-3803. Your provider can also submit for a coverage review electronically for commercial or Medicare plans, or by contacting our Pharmacy Help Desk.

You can also look on your plan’s drug list (a list of approved medications). On a regular drug list, if your medication has a PA after its name, you need to get prior authorization. Most plans also have a special list of drugs that need prior authorization.

Medicare members

Locate your plan on our Medicare drug list page. You'll be able to find your plan's prior authorization and step therapy guidelines there.