Drug coverage is limited to prescription products approved by the Food and Drug Administration as evidenced by a New Drug Application (NDA), Abbreviated New Drug Application (ANDA), or Biologics Licensed Application (BLA) on file. Any legal requirements or group specific benefits for coverage will supersede this (e.g. preventive drugs per the Affordable Care Act).
Drug coverage may also be subject to policy guidelines or exclusions established by Blue Cross and Blue Shield of Alabama. The following guidelines are meant to help members understand the requirements related to their drug coverage. These drugs may require a doctor’s request for preapproval or prior authorization.
Please note: Some employer groups may have specific drug coverage requirements for their employees that are not included in the criteria below.
*Coverage Benefit - (P) Pharmacy Benefit, (M) Medical Benefit, (B) Both
Search by Drug Name
|Product Name||Guideline||*Coverage Benefit||Implementation Date||Change Date|
|QNASL CHILDREN®||The limits are 1 inhaler per month.||P||04/01/15|
|QNASL®||The limits are 1 bottle per 30 days.||P||07/01/12|
|QUALAQUIN®||The limits are 42 capsules per 90 days, which allows for a single 7-day course of therapy.||P||05/01/07||01/01/12|
|QUILLIVANT XR||The limits are 360 mL per 30 days.||P||04/01/13|
|QVAR®||The limits are 1 boxes per 30 days for 40mcg strength and 3 boxes per 30 days for 80mcg 7.3 grams and 2 boxes per 30 days for 80mcg 8.7 grams.||P||08/06/08||04/01/11|