Blue Care Network: Medical Benefit Drugs
This page offers resources for providers who request prior authorization for physician-administered (infusible/injectable) drugs billed under the medical benefit for Blue Care Network commercial and BCN AdvantageSM members.
Need additional assistance?
For additional help, call the Pharmacy Clinical Help Desk at 1-800-437-3803.
Out-of-network providers can use the following online forms to submit requests:
Note:
Autism benefits for Blue Cross commercial, and BCN commercial members comply with Michigan-mandated benefits. The mandate doesn’t apply to some self-funded employer groups or to Medicare Advantage or Medicare supplement plans, such as Medicare Plus BlueSM, Blue Cross Complete (Medicaid), BCN AdvantageSM or MyBlue MedigapSM. Always check member benefits and eligibility.
How to submit prior authorization requests
To learn how to submit requests, see our Getting Started page.
Submit requests before providing services.
Utilization management criteria
To view, visit our Utilization management criteria page.
Frequently accessed documents
Additional resources
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