Benefily
No prior authorization

Does Bluecross Blueshield Of Tennessee, INC. require prior authorization for Signifor?

Bluecross Blueshield Of Tennessee, INC. does not require prior authorization for Signifor on the Medicare Part D plans that cover it.

No covering plan from this payer files a prior-authorization requirement for this drug.

By product strength

RxNorm productPlans coveringRequire prior authStep therapyQty limitStatus
1 ML pasireotide 0.3 MG/ML Injection [Signifor]136411417 / 17000No prior authorization
1 ML pasireotide 0.6 MG/ML Injection [Signifor]136411817 / 17000No prior authorization
1 ML pasireotide 0.9 MG/ML Injection [Signifor]136412217 / 17000No prior authorization

Product names come from RxNorm (U.S. National Library of Medicine).

Plan-by-plan detail — 1 ML pasireotide 0.3 MG/ML Injection [Signifor]

Signifor has 3 products in the corpus; this table is for 1 ML pasireotide 0.3 MG/ML Injection [Signifor], the one carried on the most plans. The product table above covers every strength.

PlanContractTierPrior authStep therapyQty limit
BlueAdvantage Diamond (PPO)H7917-0095NoNoNo
BlueAdvantage Diamond (PPO)H7917-0105NoNoNo
BlueAdvantage Diamond (PPO)H7917-0115NoNoNo
BlueAdvantage Extra (PPO)H7917-0415NoNoNo
BlueAdvantage Garnet (PPO)H7917-0325NoNoNo
BlueAdvantage Garnet (PPO)H7917-0335NoNoNo
BlueAdvantage Ruby (PPO)H7917-0125NoNoNo
BlueAdvantage Ruby (PPO)H7917-0135NoNoNo
BlueAdvantage Ruby (PPO)H7917-0145NoNoNo
BlueAdvantage Ruby (PPO)H7917-0155NoNoNo
BlueAdvantage Sapphire (PPO)H7917-0305NoNoNo
BlueAdvantage Sapphire (PPO)H7917-0315NoNoNo
BlueAdvantage Sapphire (PPO)H7917-0385NoNoNo
BlueAdvantage Sapphire (PPO)H7917-0405NoNoNo
BlueAdvantage Total Heart and Diabetes (PPO C-SNP)H7917-0445NoNoNo
BlueAdvantage Total Heart and Diabetes (PPO C-SNP)H7917-0455NoNoNo
BlueAdvantage Total Heart and Diabetes Plus (PPO C-SNP)H7917-0465NoNoNo
Source
Monthly Prescription Drug Plan Formulary and Pharmacy Network Information — Basic Drugs Formulary File
Effective
2026-06-30
Retrieved
2026-07-19
SHA-256
e626e6bcda1aa6a0071e6f0df6bafe686ae41842cdf0a9feffdc649b6d3ff3ae

We publish the hash of the exact file we ingested so any answer can be audited against the bytes CMS served that day.

Signifor at other payers

Or see Signifor across every payer at once.

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.