Blue Cross Blue Shield of Michigan · Prior auth
Blue Cross Blue Shield of Michigan prior authorization criteria
Submission criteria, documentation packets, and P2P prep by drug — for prescribers and PA staff. 30-day standard PA decision.
Standard PA decision
30 days
Appeal window if denied
180 days
Drugs covered
62
Blue Cross Blue Shield of Michigan reviews prior-authorization requests against its published medical policies — diagnosis with ICD-10 code, documented step-therapy history, and prescriber attestation of medical necessity. Standard PA decisions return in 30 days; if denied, prescribers and members have 180 days to appeal. Criteria by drug below.
Prior authorization criteria by drug
Each page covers Blue Cross Blue Shield of Michigan's submission criteria, the documentation packet, and peer-to-peer prep for that drug.
- Adalimumab at Blue Cross Blue Shield of Michigan →
- Aflibercept at Blue Cross Blue Shield of Michigan →
- Apixaban at Blue Cross Blue Shield of Michigan →
- Atezolizumab at Blue Cross Blue Shield of Michigan →
- Atogepant at Blue Cross Blue Shield of Michigan →
- Benralizumab at Blue Cross Blue Shield of Michigan →
- Bevacizumab at Blue Cross Blue Shield of Michigan →
- Bictegravir at Blue Cross Blue Shield of Michigan →
- Buprenorphine at Blue Cross Blue Shield of Michigan →
- Dapagliflozin at Blue Cross Blue Shield of Michigan →
- Dulaglutide at Blue Cross Blue Shield of Michigan →
- Dupilumab at Blue Cross Blue Shield of Michigan →
- Eculizumab at Blue Cross Blue Shield of Michigan →
- Elexacaftor Tezacaftor Ivacaftor at Blue Cross Blue Shield of Michigan →
- Empagliflozin at Blue Cross Blue Shield of Michigan →
- Erenumab at Blue Cross Blue Shield of Michigan →
- Evolocumab at Blue Cross Blue Shield of Michigan →
- Faricimab at Blue Cross Blue Shield of Michigan →
- Fingolimod at Blue Cross Blue Shield of Michigan →
- Fremanezumab at Blue Cross Blue Shield of Michigan →
- Galcanezumab at Blue Cross Blue Shield of Michigan →
- Glecaprevir Pibrentasvir at Blue Cross Blue Shield of Michigan →
- Guselkumab at Blue Cross Blue Shield of Michigan →
- Ibrutinib at Blue Cross Blue Shield of Michigan →
- Imatinib at Blue Cross Blue Shield of Michigan →
- Inclisiran at Blue Cross Blue Shield of Michigan →
- Infliximab at Blue Cross Blue Shield of Michigan →
- Ixekizumab at Blue Cross Blue Shield of Michigan →
- Lenalidomide at Blue Cross Blue Shield of Michigan →
- Liraglutide at Blue Cross Blue Shield of Michigan →
- Lisdexamfetamine at Blue Cross Blue Shield of Michigan →
- Mepolizumab at Blue Cross Blue Shield of Michigan →
- Methylphenidate at Blue Cross Blue Shield of Michigan →
- Naltrexone at Blue Cross Blue Shield of Michigan →
- Natalizumab at Blue Cross Blue Shield of Michigan →
- Nintedanib at Blue Cross Blue Shield of Michigan →
- Nivolumab at Blue Cross Blue Shield of Michigan →
- Nusinersen at Blue Cross Blue Shield of Michigan →
- Ocrelizumab at Blue Cross Blue Shield of Michigan →
- Ofatumumab at Blue Cross Blue Shield of Michigan →
- Omalizumab at Blue Cross Blue Shield of Michigan →
- Ozanimod at Blue Cross Blue Shield of Michigan →
- Palbociclib at Blue Cross Blue Shield of Michigan →
- Pembrolizumab at Blue Cross Blue Shield of Michigan →
- Pirfenidone at Blue Cross Blue Shield of Michigan →
- Ribociclib at Blue Cross Blue Shield of Michigan →
- Rimegepant at Blue Cross Blue Shield of Michigan →
- Risankizumab at Blue Cross Blue Shield of Michigan →
- Rituximab at Blue Cross Blue Shield of Michigan →
- Rivaroxaban at Blue Cross Blue Shield of Michigan →
- Sacubitril Valsartan at Blue Cross Blue Shield of Michigan →
- Secukinumab at Blue Cross Blue Shield of Michigan →
- Semaglutide at Blue Cross Blue Shield of Michigan →
- Sofosbuvir at Blue Cross Blue Shield of Michigan →
- Tafamidis at Blue Cross Blue Shield of Michigan →
- Tenofovir Alafenamide at Blue Cross Blue Shield of Michigan →
- Tezepelumab at Blue Cross Blue Shield of Michigan →
- Tirzepatide at Blue Cross Blue Shield of Michigan →
- Tofacitinib at Blue Cross Blue Shield of Michigan →
- Trastuzumab at Blue Cross Blue Shield of Michigan →
- Upadacitinib at Blue Cross Blue Shield of Michigan →
- Ustekinumab at Blue Cross Blue Shield of Michigan →
Generate a Blue Cross Blue Shield of Michigan PA packet
Open ApprovalHelp — generate a prior-auth packet tailored to Blue Cross Blue Shield of Michigan's criteria, with prescriber attestation and step-therapy documentation pre-filled.
Get started →Contact: hello@approvalhelp.com