Pharmacy Benefit Medications

Prior approval may be required for certain prescription drugs before they can be covered under the pharmacy benefit. Contact CVS Caremark at 1 (800) 624-5060 to request prior approval or to obtain a list of the drugs that require prior approval on the pharmacy benefit.

Medical Benefit Medications

The following Medical Benefit Medications require prior approval for Blue Cross and Blue Shield Federal Employee Program® (BCBS FEP®) members on Standard Option, Basic Option and FEP Blue Focus plans.

  • Medication-specific fax forms are located next to the medication name in the list below
  • Fax completed forms to 1 (844) 652-8285

FEP Medical Policy Manual

View associated policies on the FEP website. For questions about these policies, contact FEP Provider Service at 1 (877) 668-4654.

Search tips:

  • Find Fasenra and Nucala policies using the search term “IL-5 Antagonists”
  • Find Simponi Aria using search term “Simponi”
  • Find branded leuprolide products such as Lupron and Eligard using the search term “leuprolide”