BCBSFL Prior Authorization Web Form
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Androgens and Anabolic Steroids Initial
Androgens and Anabolic Steroids Renewal
Biologic Immunomodulators Initial
Biologic Immunomodulators Renewal
CGRP Inhibitors Acute (Nurtec, Ubrelvy) Initial Authorization
CGRP Inhibitors Preventative (Aimovig, Emgality, Ajovy) Initial Authorization
CGRP Inhibitors Renewal Authorization
Constipation Agents (Amitiza, Linzess, Trulance)
Glucagon-like peptide agonists (GLP-1) (Adlyxin, Bydureon, Byetta, Ozempic, Tanzeum, Trulicity, Victoza)
Opioids (Extended Release)
Opioids (Immediate Release)
PCSK9 Inhibitors Initial Authorization for Clinical Atherosclerotic Cardiovascular Disease (ASCVD)
PCSK9 Inhibitors Initial Authorization for Heterozygous Familial Hypercholesterolemia (HeFH) or Primary Hyperlipidemia
PCSK9 Inhibitors Initial Authorization for Homozygous Familial Hypercholesterolemia (HoFH)
PCSK9 Inhibitors Renewal Authorization
Stimulants [Provigil (modafinil), Nuvigil (armodafinil)]
Topical products for atopic dermatitis [Protopic (tacrolimus), Elidel (pimecrolimus), Eucrisa]
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Other - Not Listed