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For members who have prescription drug coverage through Independence Blue Cross, prior authorization is required for coverage of certain prescribed covered drugs. The approval criteria was developed and endorsed by the Pharmacy and Therapeutics Committee and are based on information from the U.S. Food and Drug Administration, manufacturers, medical literature, actively practicing consultant physicians, and appropriate external organizations.
All requests will be reviewed by FutureScripts®, our independent pharmacy benefits manager, on behalf of Independence.
A request form must be completed for all medications that require prior authorization. Submit by fax using the forms posted at:
Request form instructions
- When completing a prior authorization form, be sure to supply all requested information.
- Fax completed forms to FutureScripts at 1-888-671-5285 for review. Make sure you include your office telephone and fax numbers.
- You will be notified by fax if the request is approved. If the request is denied, you and your patient will receive a denial letter.
- If you have not received a response after two business days from when you submitted your completed form, please call FutureScripts at 1-888-678-7012.
- Take the appropriate request form to your physician to be completed.
- You or your physician should fax the completed form to FutureScripts at 1-888-671-5285 for review.
- If you have not received a response after two business days from when your completed form was submitted, please contact the physician who requested your prior authorization.
As with all our preapproval requirements, the prior authorization form must be completed in full to avoid delay. If you have questions about the preapproval process, call 1-800-ASK-BLUE.