Pharmacy Management

Access forms and resources online so you can get the information you need.

Request a Formulary Exception

Formulary Review Requests (Non-Medicare Only)

Physicians and other healthcare professionals may ask for a product to be added to the formulary. Please provide clinical studies, safety data, unique qualities, etc. to support your recommendation. Also, please let us know if the formulary review was requested by a pharmaceutical representative. Send your request to:

Blue Cross and Blue Shield of Nebraska
Attn: Pharmacy Director
1919 Aksarben Drive
P.O. Box 3248
Omaha, NE 68180-0001

Formulary Exception Review Requests (Qualified Health Plans Only)

Physicians and other healthcare professionals may ask for coverage of an Essential Health Benefit medication not covered on the formulary. Not all medications are covered based on coverage guidelines provided in regulation and member contracts.

Download the Formulary Exception Form (Qualified Health Plans only)

Formulary Exception Review Requests

Physicians and other healthcare professionals may ask for coverage of a medication not covered on the formulary.

Download the Formulary Exception Form (PDL 20 and 30 only)

Submit Pharmacy Preauthorization

Pharmacy Preauthorization

As part of our commitment to managing rising prescription drug costs while maintaining access to high-quality, cost-effective pharmacy care, BCBSNE requires prior authorization for certain medications. To determine whether your medication requires prior authorization, please refer to the applicable Prescription Drug Lists (PDLs).

Additional medications may require preauthorization per individual contract. You may also refer to our Outpatient Drug Exclusions List for members. If you are unable to submit a pharmacy preauthorization online through NaviNet, you can print the form. See all pharmacy preauthorizations forms.

Submit a Pharmacy Pre-Authorization Online »

Please use the appropriate ICD-10 codes.