Blue Advantage Part B Provider-Administered Drug Precertification Program

Blue Advantage covers certain Part B medications that are given by your healthcare provider in an office/infusion clinic, outpatient facility or home setting. The medications covered under Part B must be medically necessary according to the guidelines and policies established by the Centers for Medicare & Medicaid Services (CMS).

Precertification is a process by which a provider is required to obtain approval for a medication or service before the medication or service will be covered.

Click here for the list of medications that require precertification.

Blue Advantage Part B Drug Step Therapy Program

Effective January 1, 2025, certain drugs in the Part B Drug Step Therapy Program are changing from non-preferred to preferred status*. Review the list below to determine which drugs require precertification or are subject to step therapy (i.e., they will be approved with a valid prescription) for Blue Advantage patients.