医疗和B部分药物事先授权
事先授权是指您的医生在使用特定药物或进行特定医疗服务或手术之前必须获得Blue Shield的批准。如果没有获得事先批准,Blue Shield可能不会支付您的药物或医疗护理费用,您将需要自付费用。
医疗护理
获取针对您接受的医疗护理和药物进行决策时所采用的标准。
B部分药物
B部分药物是指您在医生办公室或医院诊所获得的药物。
关于B部分阶段治疗
如果您加入了Blue Shield Select(PPO)或Blue Shield Medicare(PPO)计划,您的B部分药物可能需要符合阶段治疗要求。
查看B部分阶段治疗标准:
关于B部分药物授权
如果您加入了Blue Shield Select(PPO)、Blue Shield Medicare(PPO)计划、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部分药物可能需要获得事先授权。
查看B部分药物标准
- 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
页面最后更新日期:2025年1月1日