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BLUE REVIEWSM

for Providers

June 2024

Medicaid Update: Pharmacy Appeals Transition Reminder

As previously communicated in News and Updates, pharmacy prior authorization appeals for Blue Cross Community Health PlansSM members are now handled through Prime Therapeutics. The appeal requests can be initiated through Prime as noted below.

Online:
Fax:
Phone:
Mail:

CoverMyMeds® or MyPrime
855-212-8110
855-457-0173
Prime Therapeutics Appeals Department
2900 Ames Crossing Road
Eagan, MN 55121

The Authorized Representative Designation Form, signed by the member, must be submitted with the appeal. The ARD form at the link above is only valid for one year.

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Prime Therapeutics LLC is a pharmacy benefit management company. Blue Cross and Blue Shield of Illinois contracts with Prime Therapeutics to provide pharmacy benefit management and other related services. BCBSIL, as well as other independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics LLC.

CoverMyMeds is a registered trademark of CoverMyMeds LLC, an independent third party vendor that is solely responsible for its products and services. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors.

If you have any questions regarding the ‭products or services they offer, you should contact the vendor(s) directly.