Starting July 1, we’ll change how we pay for certain drugs that must be administered by a health care provider

Our goal at Blue Cross Blue Shield of Michigan and Blue Care Network is to provide our members with safe, high-quality prescription drug therapies. We continually review prescription drugs to help ensure we provide the best value for our members, control costs and make sure our members are using the right drug for the right situation. Starting July 1, 2023, we’ll change how we pay for certain drugs.

We’ll no longer pay for the drugs listed below with the member’s prescription drug benefit. Since these drugs should only be administered by a health care provider, we’ll pay for them under the member’s medical benefit. Our prescription drug benefits only pay for drugs that can be self-administered by the patient, per prescription labeling approved by the U.S. Food and Drug Administration.

This change affects all pharmacy drug lists where the drug is currently covered by the pharmacy benefit.

We’ll send letters to affected groups, members and their providers about this change. And we’ll advise members to talk with their doctor about continuing to receive their drug therapies and how certain drugs should be billed to their medical benefit, starting July 1.