To help make sure Blue Cross Blue Shield of Michigan and Blue Care Network members receive the most appropriate and cost-effective therapy, we sometimes require providers to take additional steps before certain drugs are covered.
We sometimes require providers request prior authorization for certain medicines, like specialty drugs, to ensure certain clinical criteria are met.
Providers can request prior authorization electronically for:
You can find how to submit a request, details on specific drug requirements and additional resources on these pages:
Step therapy requires that the member has tried an alternative therapy first, or that their physician has clinically documented why they cannot take the alternative therapy. Step therapy may include select over-the-counter products.