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Blue Cross Blue Shield (affiliate) prior authorization requirements

Drug-by-drug prior authorization status for Blue Cross Blue Shield (affiliate)’s Medicare Part D plans, taken from the formularies it files with CMS, effective 2026-06-30.

Commonly checked drugs

CMS contract entities grouped under this brand

CMS files name the legal entity, not the brand a person searches for. These are the entities we group under “Blue Cross Blue Shield (affiliate)”, so you can check the grouping yourself.

  • BCBS OF MASSACHUSETTS HMO BLUE, INC.
  • BCBS OF ALABAMA & UTIC INSURANCE COMPANY
  • BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY
  • BCBSM, Inc.
  • BLUE CROSS & BLUE SHIELD OF RHODE ISLAND
  • BLUE CROSS AND BLUE SHIELD OF ALABAMA
  • BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.
  • BLUE CROSS AND BLUE SHIELD OF KANSAS
  • BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA
  • BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA
  • BLUE CROSS OF CALIFORNIA
  • BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.
  • BLUE CROSS OF IDAHO HEALTH SERVICE, INC.
  • CAREFIRST ADVANTAGE DSNP, INC.
  • CAREFIRST ADVANTAGE PPO, INC.
  • HIGHMARK BCBSD INC.
  • HIGHMARK BCBSD, INC.
  • HIGHMARK CHOICE COMPANY
  • HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.
  • HIGHMARK SENIOR HEALTH COMPANY
  • HIGHMARK SENIOR SOLUTIONS COMPANY
  • Highmark Western and Northeastern New York Inc.
  • ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY
  • REGENCE BLUECROSS BLUESHIELD OF OREGON
  • REGENCE BLUECROSS BLUESHIELD OF UTAH
  • REGENCE BLUESHIELD
  • WELLMARK IA & SD, & BCBS MN, MT, NE, ND,& WY
  • WELLMARK ADVANTAGE HEALTH PLAN, INC.