醫療和B部份藥物的預先授權
預先授權是指您的醫生在開立特定藥物或執行特定醫療服務或手術之前必須先取得Blue Shield的核准。沒有此項事先核准,Blue Shield可能不會支付您的藥物或醫療費用,此時您必須自付費用。
醫療護理
取閲用來決定您所接受醫療護理的標準。
B部份藥物
B部份藥物是指您在醫生的診所或醫院的門診取得的藥物。
關於B部份漸進式治療
如果您參保了Blue Shield Select (PPO)或Blue Shield Medicare (PPO)計劃,您的B部份藥物可能必須遵循漸進式治療的規定。
查看B部份漸進式治療的標準:
關於B部份藥物授權
如果您參保了以下計劃:Blue Shield Select (PPO)、Blue Shield Medicare (PPO)計劃、Blue Shield 65 Plus (HMO)、Blue Shield 65 Plus Choice Plan (HMO)、Blue Shield 65 Plus Plan 2 (HMO)、Blue Shield AdvantageOptimum Plan (HMO)、Blue Shield AdvantageOptimum Plan 1 (HMO)、Blue Shield Inspire (HMO D-SNP)、Blue Shield Inspire (HMO)和Blue Shield TotalDual Plan (HMO D-SNP);您的B部份藥物可能必須遵循預先授權的規定。
查看B部份藥物的標準
- Drug Name
- abobotulinumtoxinA (Dysport)
- aflibercept (Eylea, Eylea HD)
- bevacizumab (Avastin)
- bevacizumab-adcd (Vegzelma)
- bevacizumab-awwb (Mvasi)
- bevacizumab-bvzr (Zirabev)
- bevacizumab-maly (Alymsys)
- darbepoetin alfa (Aranesp)
- denosumab (Prolia)
- denosumab (Xgeva)
- eflapegrastim-xnst (Rolvedon)
- epoetin alfa (Epogen, Procrit)
- epoetin alfa-eobx (Retacrit)
- faricimab-svoa (Vabysmo)
- filgrastim (Neupogen)
- filgrastim-aafi (Nivestym)
- filgrastim-ayow (Releuko)
- filgrastim-sndz (Zarxio)
- imiglucerase (Cerezyme)
- immune globulin intravenous
- immune globulin intravenous, human (Bivigam)
- immune globulin intravenous, human (Flebogamma DIF)
- immune globulin intravenous, human (Gammagard liquid)
- immune globulin intravenous, human (Gammaked)
- immune globulin intravenous, human (Gammaplex)
- immune globulin intravenous, human (Gamunex-C)
- immune globulin intravenous, human (Octagam)
- immune globulin intravenous, human (Privigen)
- immune globulin intravenous, human-ifas (Panzyga)
- immune globulin intravenous, human-slra (Asceniv)
- immune globulin subcutaneous
- immune globulin subcutaneous, human (Cuvitru)
- immune globulin subcutaneous, human (Gammagard liquid)
- immune globulin subcutaneous, human (Gammaked)
- immune globulin subcutaneous, human (Gamunex-C)
- immune globulin subcutaneous, human (Hizentra)
- immune globulin subcutaneous, human with recombinant human hyaluronidase (Hyqvia)
- immune globulin subcutaneous, human-hipp (Cutaquig)
- immune globulin subcutaneous, human-klhw (Xembify )
- incobotulinumtoxinA (Xeomin)
- infliximab (Remicade)
- Infliximab-abda (Renflexis)
- Infliximab-axxq (Avsola)
- Infliximab-dyyb (Inflectra)
- methoxy polyethylene glycol-epoetin beta (Mircera)
- onabotulinumtoxinA (Botox)
- Pegfilgrastim (Neulasta)
- Pegfilgrastim-apgf (Nyvepria)
- Pegfilgrastim-bmez (Ziextenzo)
- Pegfilgrastim-cbqv (Udenyca)
- Pegfilgrastim-fpgk (Stimufend)
- Pegfilgrastim-jmdb (Fulphila)
- Pegfilgrastim-pbbk (Fylnetra)
- pembrolizumab (Keytruda)
- rimabotulinumtoxinB (Myobloc)
- rituximab (Rituximab)
- rituximab-abbs (Truxima)
- rituximab-arrx (Riabni)
- rituximab-pvvr (Ruxience)
- romosozumab-aqqg (Evenity)
- taliglucerase alfa (Elelyso)
- tbo-filgrastim(Granix)
- trastuzumab (Herceptin)
- trastuzumab-anns (Kanjinti)
- trastuzumab-dkst (Ogivri)
- trastuzumab-dttb (Ontruzant)
- trastuzumab-pkrb (Herzuma)
- trastuzumab-qyyp (Trazimera)
- velaglucerase alfa (VPRIV)
Y0118_24_782A_C 11152024
H2819_24_782A1_C Accepted 11302024
頁面最後更新日期:2025年1月1日