Pharmacy Information And Tools
Healthy Blue will administer pharmacy benefits for enrolled members. CarelonRx* is the pharmacy benefit manager.
Please refer to the Healthy Blue Preferred Drug List (PDL) when prescribing for our members. This guide does not contain a complete list of drugs; rather, it lists the preferred drugs within the most commonly prescribed therapeutic categories.
Though most medications on the PDL are covered without prior authorization, a few agents will require you to contact our Pharmacy department for authorization.
Electronic prior authorizations (ePA)
Using CoverMyMeds for prior authorization (PA) requests
Prior Authorizations By Phone:
You can reach our Pharmacy department at 833-388-1406 between 7 a.m. and 8 p.m. CST Monday to Friday.
Prior Authorizations By Fax:
You can also fax your request to our Pharmacy department:
Retail prior authorization:
Pharmacy Hot Tips are brief messages to help answer questions and/or concerns you may have around a variety of pharmacy topics. Topics include preferred formulary products used to treat common diseases and conditions such as asthma and diabetes.
If you would like additional pharmacy information to assist our members, contact your Provider Relations representative, and we will prepare a pharmacy Hot Tip for you!
* CarelonRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Healthy Blue.
Provider Tools & Resources
- Log In To Availity
- Launch Provider Learning Hub Now
- Learn About Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Policies, Guidelines & Manuals
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)
- Quality of Care Form