Additional drugs require prior authorization for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans, starting Jan. 27

For dates of service on or after Jan. 27, 2022, we're adding prior authorization requirements for the following drugs covered under the medical benefit for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans:

  • Blenrep™ (belantamab mafodotin-blmf), HCPCS code J9037
  • Jemperli™ (dostarlimab-gxly), HCPCS codes J3490, J3590, J9999, C9082
  • Monjuvi® (tafasitamab-cxix), HCPCS code J9349
  • Zynlonta® (loncastuximab tesirine-lpyl), HCPCS codes J3490, J3590, J9999, C9084

Submit prior authorization requests through AIM Specialty Health®.

Notes:

  • Prior authorization requirements apply when these drugs are administered in an outpatient setting.
  • This requirement doesn’t apply to the UAW Retiree Health Care Trust (group number 70605) or the UAW International Union (group number 71714).

How to submit authorization requests

Submit prior authorization requests to AIM using one of the following methods:

More about the authorization requirements

Authorization isn't a guarantee of payment. As always, health care practitioners need to verify eligibility and benefits for members.

For additional information on requirements related to drugs covered under the medical benefit for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans, see:

We'll update the appropriate drug lists to reflect the information in this message prior to the effective date.

Note: Accredo manages prior authorization requests for additional medical benefit drugs.

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Posted: October 2021
Line of business: Blue Cross Blue Shield of Michigan