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Prescription Drug Prior Authorization

Some drugs require authorization before they will be covered by the pharmacy benefit program at the point of sale. Highmark West Virginia members may have prescription drug benefits that require prior authorization for selected drugs. Program designs differ. Call the Provider Service Center at 1-800-543-7822, for information regarding specific plans.

For all other Highmark West Virginia members, complete the Prescription Drug Medication Request Form and mail it to the address on the form.

To search for drugs and their prior authorization policy, select Pharmacy Policies - SEARCH on the left menu or at the top of the page.

Last updated on 1/9/2019 11:00:39 AM

 

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Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration.