Medical benefit specialty drug prior authorization list changing in April for most members
Starting in April 2021, we're adding prior authorization requirements for some drugs covered under the medical benefit. Providers must request prior authorization through AIM Specialty Health®.
April 15 changes
For dates of service on or after April 15, 2021, the following drug will require prior authorization for UAW Retiree Medical Benefits Trust PPO non-Medicare members:
April 22 changes
For dates of service on or after April 22, 2021, the following drugs will require prior authorization for members covered through Blue Cross commercial fully insured members and for BCN commercial, Medicare Plus BlueSM and BCN AdvantageSM members:
These requirements don't apply to:
How to submit authorization requests
Submit authorization requests to AIM using one of the following methods:
For information about registering for and accessing the AIM ProviderPortal, see the Frequently asked questions page* on the AIM website.
More about the authorization requirements
Authorization isn't a guarantee of payment. Health care practitioners need to verify eligibility and benefits for members.
For additional information on requirements related to drugs covered under the medical benefit, see:
We'll update these lists to reflect these changes prior to the effective dates.
*Clicking this link means that you're leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website. While we recommend this site, we're not responsible for its content.
Posted: January 2021
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network