Starting Jan. 1, 2020, Blue Cross' PPO and BCN HMOSM plans will cover hemophilia drugs under members' pharmacy benefits

Starting Jan. 1, 2020, Blue Cross Blue Shield of Michigan and Blue Care Network will change how we cover hemophilia drugs for commercial (PPO and HMO) members. If a member has Blue Cross' PPO or BCN HMO pharmacy coverage, all hemophilia drugs should be billed under his or her pharmacy benefits.

This change doesn't affect all commercial members. For example, if a member has pharmacy coverage through a company other than Blue Cross or BCN, hemophilia drugs will continue to be covered under the medical benefit.

To determine whether this change applies to a specific member:

We'll notify affected members of these changes. Members don't have to do anything. Their medication and treatment won't change.

For complete details, see the We'll cover hemophilia drugs under the pharmacy benefit for most commercial members, starting Jan. 1 article in the October 2019 issue of The Record. A similar article will appear in the November-December 2019 issue of BCN Provider News.

Posted: September 2019
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network