Disease Specific Drugs Requiring Prior Authorization

Disease Specific Drugs treat certain chronic disease states such as rheumatoid arthritis, hepatitis, and multiple sclerosis. Disease Specific Drugs treat complex conditions, require special administration, monitoring, education, frequent dosage adjustments and have unusually high costs.

Disease Specific Drug benefits can vary depending on the member's Benefit Plan. Your financial responsibility may be either a co-payment or co-insurance amount. Members should refer to their Benefit Plan for their specific out-of-pocket expense responsibility.

All Disease Specific Drugs must be prescribed by a Network Physician, prior authorized by Blue Cross & Blue Shield of Mississippi, and dispensed by a Disease Specific Pharmacy or Non-Pharmacy Network Provider to be covered. Your Network Physician is responsible for submitting a prior authorization request directly to Blue Cross & Blue Shield of Mississippi for approval.

Listed below are the Disease Specific Drugs included in the Disease Specific Formulary. Some Benefit Plans have a closed formulary for certain drugs. *Certain Growth Hormone Disease Specific Drugs are subject to a closed formulary based upon a member's health benefit plan.

If you have questions about a Disease Specific Drug or your benefits, please call our Customer Service Center at 601-664-4590 or 800-942-0278.