Dear Valued Provider,

Effective January 1, 2016, Blue Cross and Blue Shield of Alabama is adding a new definition to their prescription drug guidelines for Commercial and Health Insurance Marketplace (HIM) plans. This definition clarifies coverage of prescription products approved by the Food and Drug Administration (FDA). Prescriptions for products not approved by the

FDA are not covered. FDA-approved drug coverage will be defined as follows: coverage is limited to prescription products approved by the Food and Drug Administration (FDA) as evidenced by a New Drug Application (NDA), Abbreviated New Drug Application (ANDA), or Biologics License 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).

Please download attached PDF file for more information.