Skip to Content
Some prescription drugs require approvals before you can take them. Here is a list of prior authorization drugs for Medicare BlueSM Private Complete (PFFS) or Medicare BlueSM Private Complete Plus (PFFS) members. You can click on the name of the medication and print the attached authorization form. Ask your provider to complete the form and fax it to the Prior Authorizations department at 1-888-836-0730. Drugs with an asterisk are only included on the Medicare Blue Private Complete Plus (PFFS) plan. All other drugs apply to both Medicare Blue Private Complete (PFFS) and Medicare Blue Private Complete Plus (PFFS).
Cost-Sharing Tier 5
