Plan Options

• MedicareBlue PPO
  • 2008 Benefits at a Glance (PDF)
  • 2008 Enrollment Guide (PDF)
  • 2008 Summary of Benefits (PDF)
  • 2008 Evidence of Coverage
  • Prior Authorization
  • Quantity Limits
  • Questions & Answers
  • Complaints & Appeals (PDF)
  • Request Information
  • Enroll Now
• MedicareBlue Rx
  • 2008 Benefits at a Glance (PDF)
  • 2008 Enrollment Guide (PDF)
  • 2008 Summary of Benefits (PDF)
  • 2008 Evidence of Coverage
  • Pharmacy Benefit Manager
  • Complaints & Appeals (PDF)
  • Questions & Answers
  • Request Information
  • Prior Authorization
  • Quantity Limits
  • Step Therapy
  • Enroll Now
• Medicare Supplement Plans & Other Options
• Group Plans

MedicareBlue Rx

Prior Authorization

For MedicareBlue Rx coverage, prior authorization is required for certain covered drugs that have been approved by the Food and Drug Administration (FDA) for specific medical conditions.

In the event you need a prior authorization, we encourage your prescribing physician to use the appropriate physician request for prior authorization form and fax it to the number provided on the form for all medications requiring prior authorization. Following are the prior authorization program guidelines:

• The prescribing physician can fax the prior authorization form to MedicareBlue Rx in advance about the medical condition that requires the use of drugs that appear on the prior authorization list; getting the authorization in advance prevents delays at the pharmacy.
• Contact Customer Service for MedicareBlue Rx:

Toll Free 1-888-832-0075
TTY/TDD users should call 1-800-693-3819
8:00 a.m. to 8:00 p.m., daily, Central and Mountain Time

Once the drug is authorized, it can be filled at any participating pharmacy (except for the few drugs which may require a specialty pharmacy; check with your physician).

Search the drug formulary to find out if your drug requires prior authorization.