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Final Provider-Administered Oncology Drug Policies
The drugs below require that a member’s medical condition meets the policy requirements prior to being given (precertification).
Providers must submit a request through Magellan Rx for pre-service review in order to be approved. If the provider does not receive approval for precertification, the plan will pay no benefits.
Precertification for these provider-administered drugs is required when administered in a provider’s office, outpatient facility, or home health setting.
Note: Coverage is subject to the member's specific benefits. Group-specific benefits will supersede these policies when applicable. Always check eligibility and benefits through your local Blue Plan provider portal or your practice management system to confirm member-specific benefits.
To request a copy of a drug policy, members can contact Customer Service by calling the number on their ID card.
Urgent precertification requests must be called in to MagellanRx at 1-800-424-8270.