This information applies to Medicaid members who have Blue Cross Community Health PlansSM (BCCHP) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM prescription drug benefits. (Information on this page for MMAI members is applicable for dates of service through Dec. 31, 2025.) Prime Therapeutics is the Pharmacy Benefit Manager (PBM) that provides drug benefits through Blue Cross and Blue Shield of Illinois (BCBSIL).
Drug Lists
Drug List - Blue Cross Community Health Plans
Drug List - Blue Cross Community MMAI (Medicare-Medicaid Plan)SM
Pharmacy Directory
Mail Service for BCCHP: ePrescribe new prescriptions to EXPRESS SCRIPTS HOME DELIVERY or call 888-327-9791 for faxing instructions
Accredo Specialty and Complex Care Pharmacy Fax Order Form (BCCHP) or electronic referral forms
Refer to the BCCHP Pharmacy Directory for other Pharmacy Match network pharmacies that can dispense specialty and complex care drugs
Prior Authorization
Providers can access, complete, and submit prior authorization requests using the uniform PA form. Electronic requests forms for prior authorization and step therapy requests can be submitted from the CoverMyMeds login page.
Prescription Exception Requests
Providers may submit coverage exception requests for BCCHP plans by fax, phone or electronically: Fax 877-480-8130, call 1-866-202-3474 (TTY/TDD 711) or submit electronically on MyPrime or CoverMyMeds login page.
Managed Care Organization (MCO) Pharmacist Clinical Reviews
Health care professionals should know that BCBSIL's MCO pharmacists use the Illinois Prescription Drug Monitoring Program to carry out clinical reviews for our BCCHP members. These reviews help make sure opioid prescription drug use is in compliance with the Illinois Controlled Substances Act, or House Bill 4650, and the section covering “medication and pharmacy shopping”.
The drug list and pharmacy network may change at any time.
Blue Cross Community Health Plans and Blue Cross Community MMAI plans are provided by Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an Independent Licensee of the Blue Cross and Blue Shield Association.