Additional medications will require prior authorization for most members starting May 24

For dates of service on or after May 24, 2021, we're adding prior authorization requirements for the following drugs covered under the medical benefit:

The prior authorization requirements apply when these drugs are administered in outpatient settings for:

These requirements don't apply to Blue Cross commercial self-funded groups, including:

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 the following documents:

We'll update the requirements lists with the new information prior to May 24, 2021.

*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: April 2021
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network