Prescription Drug Information

• Comprehensive Prescription Drug Claim Form  (Updated 02/2009)


• Prescription Drug Claim Form  (Updated 09/2011)

^{Note: Blue Cross and Blue Shield health plans offered by self-insured employer groups may have different coverage options, plans or benefits. Please refer to your health plan contract, which governs eligibility, coverage exclusions and available benefits.}

Your prescription drug coverage may include a specialty pharmacy program through Triessent^®, which is part of our contracting pharmacy network. Specialty medications include those used in the treatment of complex medical conditions, such as hepatitis, hemophilia, multiple sclerosis, rheumatoid arthritis and other conditions requiring self-administered specialty medications.

Through Triessent, members can have covered self-administered specialty medications delivered directly to them or their doctor’s office. When you purchase specialty medications through Triessent, you also receive at no additional charge the following services:

• Coordination of coverage between you, your doctor and Blue Cross and Blue Shield of Oklahoma
• Convenient delivery of medication to you or your physician’s office
• Educational materials about your particular condition and information about managing potential medication side effects
• Syringes, sharps containers and other supplies with every shipment for self-injectable medications
• 24/7/365 customer service phone access

View the Specialty Pharmacy Program Drug List 

View the Specialty Drug Brochure — English  Spanish 

View more about our specialty pharmacy program from Triessent. 

View the scheduled release of and projections for specialty drugs for 2011. 

The prior authorization/step therapy program is designed to encourage safe, cost-effective medication use.

This program may be part of your prescription drug benefit plan. To find out if your specific benefit plan includes the prior authorization/step therapy program, and which drugs are part of your plan, refer to your benefit booklet, or call the Pharmacy Program number on the back of your ID card.

Prior Authorization

Under this part of the program, your physician will be required to obtain authorization through Blue Cross and Blue Shield of Oklahoma in order for you to receive benefits for certain medications and drug categories.

• Examples of drug categories and specific medications for which a prior authorization program may be included as part of your prescription drug benefit plan are listed below.
• Please note that drug categories may be added and the medications listed are only examples. Call the Pharmacy Program number on the back of your ID card with questions about a specific medication.
• As always, cost is only one factor in choosing medication and treatment decisions are between you and your doctor.

†Additional categories may be added and the program may change from time to time.

*Third-party brand names are the property of their respective owners.

More information is available in the prior authorization member flier .

Step Therapy

The step therapy program requires that you have prescription history for a "first-line" medication before your benefit plan will cover a "second-line" drug.

• A first-line drug is recognized as safe and effective in treating a specific medical condition, as well as being a cost-effective treatment option.
• A second-line drug is a less-preferred or potentially more costly treatment option.

Step 1: When possible, your doctor should prescribe a first-line medication appropriate for your condition.

Step 2: If your doctor determines that a first-line drug is not appropriate for you or is not effective in treating your condition, your prescription drug benefit will cover a second-line drug when certain criteria are met.

• Below are drug categories and specific medications for which a step therapy program may be included as part of your prescription drug benefit plan.
• Step therapy does not apply to the generic equivalents for these medications (if available), so if you and your doctor decide the generic equivalent is best for you, prior authorization is not required.
• These medications are listed along with the first use approved by the U.S. Food and Drug Administration, but may be prescribed for conditions other than those noted and would still be part of the step therapy program.
• Please note that drug categories may be added and the medications listed are only examples. Call the Pharmacy Program number on the back of your ID card with questions about a specific medication.
• As always, cost is only one factor in choosing medication and treatment decisions are between you and your doctor.

†Additional categories may be added and the program may change from time to time.

*Third-party brand names are the property of their respective owners.

More information is available in the step therapy member flier .

If you have questions about the prior authorization/step therapy program, call the Pharmacy Program number on the back of your BCBSOK ID card.

Right from your home, PrimeMail^® , your mail order pharmacy, makes your health a top priority. With PrimeMail, ordering and receiving your long-term medications is easier than ever. PrimeMail provides safe, fast and cost-effective pharmacy services that can save you time and money without sacrificing quality or care. For more information and to start using the PrimeMail service, download these documents.

• PrimeMail New Prescription Order Form  (Updated 12/2010)


• PrimeMail Refill Prescription Order Form  (Updated 12/2010)


• Tips for Ordering Prescription Drugs by Mail