Blue Cross Blue Shield MA Changes Effective July 1, 2024

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By Joseph Smith

  1. Medical Policy updates effective 7/1/24. BCBSMA Medical Policies are developed by using evidence-based information to define the technologies, procedures, and treatments that are considered medically necessary, or not medically necessary, or investigational. Changes to the affected medical policies include:
    1. Step therapy policy changes
    1. Prior authorization requirements for specific medications
    1. Pharmacy formulary changes effective 7/1/24. As part of this update, certain medications may:
      1. No longer be covered (exceptions may be granted)
      1. Switch tiers
      1. Have new quantity or dosing limits
      1. Require prior authorization and/or step therapy
      1. Be added to the list of covered medications
      1. Be designated as preferred
    1. Attachments:
      1. BCBSMA Medical Policy Updates Effective July 1, 2024
      1. BCBSMA Pharmacy Formulary Drugs Being Removed Effective July 1, 2024
      1. BCBSMA Pharmacy Formulary Full List of Covered Medications Effective July 1, 2024
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