Blue Cross of California Pharmacy Services

Blue Cross of California understands that prescription drugs are an integral part of the care you receive from you Primary Care Physician. Therefore, BCC reviews pharmacy trends on a quarterly basis to identify medications available through the Prior Authorization of Benefits Program. The PAB guidelines were established to make sure that prescribing standards are followed and that the right medication is prescribed.

Most members are able to receive FDA-approved medications, although some prescriptions may need to be reviewed by BCC or may require a further reason for the drug by the prescribing physician.

Drugs that are non-preferred may be available if the prescribing physician describes the medical necessity to the dispensing pharmacist by noting ędo not substituteę or ędispense as writtenę verbally or on the written prescription. If you have been prescribed a drug that is in our previous authorization benefits list, ędo not substituteę or ędispense as writtenę does NOT apply and your primary care physician will be required to submit an authorization of benefits form. For further details, members should refer to their Evidence of Coverage (EOC) for information about exclusions and limitations.

When reading information regarding pharmacy benefits, it is important to note that this information is provided for purposes of general understanding. Information provided should not substitute a physicianęs knowledge or be considered medical advice. Only a legal practicing physician can determine which medications are appropriate to treat your ailment.

Programs discussed here are provided to give you greater insight into pharmacy benefits. You may want to refer to the applicable memberęs Evidence of Coverage (EOC) for information on plan benefits, conditions, exclusions and limitations. Pharmacy benefits management services are provided by Professional Claims Services, Inc. and WellPoint Pharmacy Management.