Skip to main content
Shop Plans Learn more about our coverage options including health, Medicare, dental and vision options for you, your family or your employees. Get Started Individual & Family Medicare Employer Vision Dental International Travel Find Care FAQ Blog Members Stay on top of your health care with helpful member resources. Members Home Medicare Health Dental Vision Find Care Member Knowledge Center Member Forms Medicare Forms Library Make a Payment Federal Employees Student Blue Healthy Blue Providers Access tools, policies and the latest information to help you care for our members. Providers Home Network Participation Networks & Programs Claims, Appeals & Inquiries Prior Authorization Services & CPT codes Prescription Drug Search Forms and Documents Policies, Guidelines & Codes Provider News Provider FAQ Contact Us Employers Learn about our coverage options for small and large employers, and access tools and resources for your group. Employers Home Shop Employer Plans Employer Portal Support Member Forms & Resources Find Care Blog Agents Access the tools you need: rate quotes, applications, forms, the latest industry news, marketing materials and more. Agents Home Agent Services Check Eligibility Find Care Member Forms & Resources Medicare Forms Library
Contact Us
Log In
I am ... Please select A member A provider An employer An agent
Log in to Agent Services
Log in to Employer Services Register for Employer Services I'm registered but need portal access
Username Forgot username? Continue to Log In Register for Blue Connect Need help? Learn how to log in.
Log in to Blue e Register for Blue e Log in to Dental Blue
Back
Xolair Transition to Self-Administered Formulation December 09, 2021 Pharmacy

Effective January 4, 2022, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will require use of the self-administered formulation of Xolair billed under the pharmacy benefit for all members who can use a self-injectable or have a caregiver that is able to administer.

If the member/caregiver can self-administer but the provider would like to continue to administer the medication in the healthcare setting for other reasons, the medication would need to be obtained from an in-network specialty pharmacy provider. The member would then need to take the medication to the provider’s office, or the specialty pharmacy can have the medication shipped directly to their office. The provider will be able to bill for the administration of the drug but not for the drug itself.

The prior authorization criteria for coverage under the pharmacy benefit can be found on the prior review plan page by searching and selecting Xolair- Pharmacy criteria. A list of in network pharmacies can be found on the Pharmacy page. Please verify all member's specific benefits and in network specialty pharmacies.

For additional information, please review the medical criteria policy for Xolair.

About Us Newsroom Blog Member Forms COVID-19 Transparency in Coverage Find Care Rights & Responsibilities Policies & Best Practices Privacy Policy Website User Agreement Fraud & Abuse Technical Information Contact Us Locations Careers

Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.

Information in other languages: Español   中文   Tiếng Việt   한국어   Français   العَرَبِيَّة   Hmoob   ру́сский   Tagalog   ગુજરાતી   ភាសាខ្មែរ   Deutsch   हिन्दी   ລາວ   日本語

© 2025 Blue Cross and Blue Shield of North Carolina. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.