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Effective Jan. 1, 2017, New Hepatitis C Recommendation for ICP and FHP members

Posted December 22, 2016

Effective Jan. 1, 2017, Blue Cross Community Integrated Care Plan (ICP)SM and Blue Cross Community Family Health PlanSM (FHP) adopted the Illinois Department of Healthcare and Family Service (IHFS) criteria for approval of newer direct-acting antivirals (DAAs) for Hepatitis C.  

Please refer to illinois.gov/hfs/MedicalProviders/notices/Pages/prn160930b.aspx for more information. If you have any questions, please contact gp-pharmacy@bcbsil.com.

Providers may submit pharmacy benefit prior authorization (PA) requests online via the CoverMyMeds® site at covermymeds.com. While electronic options are preferred, pharmacy benefit PA requests also may be called in to 800-285-9426, followed by a statement with supporting documentation, which may be faxed to 877-243-6930, or mailed. Additional information is available on the CoverMyMeds page.

CoverMyMeds is a registered trademark of CoverMyMeds LLC, an independent third party vendor that is solely responsible for its products and services. BCBSIL makes no endorsement, representations or warranties regarding any products or services offered by independent third party vendors. If you have any questions regarding the products or services they offer, you should contact the vendor(s) directly. 

Checking eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have any questions, please call the number on the member’s ID card.