High call volumes

Our member and provider services may be experiencing higher than normal call volumes from 12/22/25-1/9/26 due to a large number of staff being out of office.  We encourage you to utilize alternative forms of communication including secured messaging through online Member Services and Availity Essentials Provider Portal.

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Member and Provider Services Representatives will be unavailable Thursday, Jan. 1, due to the holiday. We are unable to accept walk-ins on Friday, Jan. 2., due to short staffing.


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Medical Drug Preferred Product Updates for December 1, 2025

Effective Dec. 1, 2025, BCBSND will be updating the preferred products within the following medical drug policies. The updated policies can be found at http://www.gatewaypa/medicalpolicy/52 on Dec. 1, 2025. Members with existing approvals for non-preferred products will be allowed to remain on the non-preferred product until their approval has expired. If a member would like to switch to a preferred product prior to the end of their approval expiration date, please contact the Medical Pharmacy Solutions Team at Prime Therapeutics at 800- 424-1708.


Infliximab

Preferred Agents
(effective Dec. 1, 2025)

Non-Preferred Agents
(effective Dec. 1, 2025)

Avsola (infliximab-axxq) - Q5121

Inflectra (infliximab-dyyb) - Q5103

Infliximab - J1745

Remicade (infliximab) - J1745

Renflexis (infliximab-abda) - Q5104



Rituximab

Preferred Agents*
(effective Dec. 1, 2025)

Non-Preferred Agent*
(effective Dec. 1, 2025)

Riabni (rituximab-arrx) – Q5123

Ruxience (rituximab-pvvr) – Q5119

Truxima (rituximab-abbs) – Q5115

Rituxan (rituximab) – J9312

*Not applicable for metastatic cancer indications



Beovu and Susvimo
(Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema)

Preferred Agent
(effective Dec. 1, 2025)

Non-Preferred Agents – Step 1
(effective Dec. 1, 2025)

A bevacizumab product

Ahzantive (aflibercept-mrbb) – Q5150

**Byooviz (ranibizumab-nuna) – Q5124

Enzeevu (aflibercept-abzv) – Q5149

Eylea (aflibercept) – J0178

Eylea HD (aflibercept) – J0177

Opuviz (aflibercept-yszy) – Q5153

Pavblu (aflibercept-ayyh) – Q5147

Lucentis (ranibizumab) – J2778

Vabysmo (faricimab-svoa) – J2777

Yesafili (aflibercept-jbvf) – Q5155

**Not applicable to diabetic macular edema



Denosumab

Preferred Agents
(effective Dec. 1, 2025)

Non-Preferred Agents
(effective Dec. 1, 2025)

Jubbonti/Wyost
(denosumab-bbdz) – Q5136

Stoboclo/Osenvelt
(denosumab-bmvo) - Q5157

Bomyntra/Conexxence
(denosumab-bnht) – Q5158

Ospomyv/Xbryk
(denosumab-dssb) – Q5159

Prolia/Xgeva
(denosumab) – J0897