Does Blue Cross Blue Shield (affiliate) require prior authorization for Glyxambi?
Prior authorization for Glyxambi differs across Blue Cross Blue Shield (affiliate)'s Medicare Part D plans and product strengths — 2 of 2 Glyxambi products in the corpus appear on their formularies, and the requirement is not uniform. Check the member's specific plan.
Some plans require authorization and others do not. The member's specific plan decides.
- Prior authorization requirements differ across this payer's plans: 3 of 240 covering plans require it. Check the specific plan the member is enrolled in — the plan name and contract number are on their insurance card.
By product strength
| RxNorm product | Plans covering | Require prior auth | Status |
|---|---|---|---|
| empagliflozin 10 MG / linagliptin 5 MG Oral Tablet [Glyxambi]1602115 | 240 / 269 | 3 | Varies by plan |
| empagliflozin 25 MG / linagliptin 5 MG Oral Tablet [Glyxambi]1602120 | 240 / 269 | 3 | Varies by plan |
Product names come from RxNorm (U.S. National Library of Medicine).
- Effective
- 2026-06-30
- Retrieved
- 2026-07-19
- SHA-256
- e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae
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Glyxambi at other payers
Administrative information only. Benefily reports what a payer has published in its own prior-authorization policy as of the effective date shown. It is not medical advice, not a coverage or payment guarantee, and not an authorization. Requirements vary by plan, place of service and member benefits — always verify with the payer before rendering service.