Hemophilia Drug Benefit Change for Commercial Members*

Blue Cross Blue Shield of North Dakota (BCBSND) is informing providers of an important benefit change for hemophilia drug products for Commercial Members.  Effective January 1, 2023, the below list of hemophilia drug products will now be covered under pharmacy benefits and will require prior authorization. These products will no longer be eligible for coverage under the medical benefit. For members wanting to receive one of the below hemophilia drug products at their pharmacy on or after January 1, 2023, providers will need to send a new prescription to an in-network specialty pharmacy of choice and a prior authorization request with required documentation to Prime Therapeutics.

*No change for Medicaid Expansion members as hemophilia drug products are currently a pharmacy benefit.

For additional questions, call the BCBSND Customer Contact Center at 1-800-368-2312.