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When a BlueChoice HealthPlan member has prescription drug benefits, the only injectable drugs available through the prescription drug coverage are Byetta, epinephrine, glucagon, Imitrex, insulin, Lovenox and Symlin. We process all other covered injectable drugs through the member’s medical coverage.
There are several injectable and infusion drugs that require prior authorization. If you administer a drug in your office that requires prior authorization (and you bill for it under your tax ID number), you can get authorization by faxing BlueChoice HealthPlan at (800) 610-5685.
If you do not administer these drugs in your office, you can get authorization for self-administered and home-use injectables by calling ICORE Healthcare at (800) 327-8648. ICORE Healthcare is an independent company that provides specialty pharmaceutical services. On behalf of BlueChoice HealthPlan, ICORE assists in the administration of the program. You can also place the order at that time for home delivery to your patient. Request home infusion medications directly through BlueChoice HealthPlan.
The member has a specialty pharmaceutical copayment for every dosing administration of specialty infusion medication and a monthly copayment for self-injectable medications.
Oral specialty medications are also subject to a specialty pharmaceutical copayment per month's supply. Please consult the member's Schedule of Benefits for copayment amounts. Members must fill these oral medications through a retail pharmacy and they are not eligible for mail order. Please contact Caremark at (800) 294-5979. On behalf of BlueChoice HealthPlan, Caremark assists in the administration of the program. Caremark is an independent company that provides pharmacy benefits management.
Look at our complete list of Injectable Medications and Specialty Pharmaceutical Drugs to learn what we cover, including which injectable drugs require prior authorization.
Please go to the ICORE Web site for Prior Authorization and Prescription Forms. Once completed, fax these forms directly to ICORE at (888) 656-2040.
Go back to the Prescription Drug Information page.
