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Knowledge Center

Drug search

Our drug search tool tells you which drugs are covered, as well as which need prior authorization.

This drug search tool is for individual and family plan members under 65. For the Medicare drug search, visit our Medicare prescription drug resources page.

To find a drug, use the search above or select a letter from the list above.

Brand Drug Name: {{header}}

results found

  • Generic Drug Name:
  • Benefit: ,
  • Specialty:
  • Prior Review Required On: ,
  • Value Prior Authorization: ,
  • Quantity Limits Required On: ,
  • Quantity Limits:
  • Restricted Access/Step Therapy:
  • Restricted Access/Step Therapy: , ,
  • Formulary Exceptions:
  • Formulary Exceptions: ,
  • Nonformulary:
  • Nonformulary On: ,
  • Criteria: ,
  • Fax Form: ,
  • Note:

No results found for '{{header}}'

Words you may see in the drug search

To encourage the proper use of prescription medications, Blue Cross NC may restrict the amount of medicine an insurance plan covers. This may mean taking fewer pills each day without changing the total strength of the medication.

Blue Cross NC requires that patients first try a medication or device that is not restricted before a restricted medication will be approved. Patients may be covered for a restricted medication if providers tell Blue Cross NC in writing that:

  • The patient has already used the non-restricted medication and it wasn't effective in treating the condition; or
  • The provider thinks the non-restricted medication is likely to be harmful to the patient's health or not effective in treating their condition.

A non-formulary medication is one that isn't on a patient's Blue Cross NC medication list. Not all medication lists or formularies have non-formulary medications. Providers must confirm that a patient has tried the medication(s) on their list first, and that they were ineffective or harmful. Also, any medication-specific clinical criteria must be met before approval (available in the Drug Search).

May be used to treat a complex or rare condition, and are generally:

  • Prescribed with special dosing or administration
  • Prescribed by a specialist
  • Significantly more expensive than alternative therapies

Specialty drugs are limited to a 30-day supply and patients must get them from an in-network specialty pharmacy, so their benefits will apply to the prescription. In-network pharmacy options vary based on the patient's plan benefits.

Need to request prior authorization?

If your drug has step therapy requirements or needs prior authorization from your health plan, our Member Knowledge Center can help you navigate next steps.