Pharmacy – Outpatient Prescription Drugs

Policy Number: GP-PI-003

Last Updated: May 3, 2022 

Under some Blue Cross and Blue Shield of Nebraska (BCBSNE) plans, benefits for certain prescription drugs and covered services administered in an outpatient setting will only be available if they are obtained from a participating pharmacy and processed under the member’s BCBSNE prescription drug plan. The list of medications that are no longer covered under the medical plan is available at

An outpatient setting includes a home, physician’s office, outpatient hospital or other outpatient facilities. It does not include a hospital emergency room.

Medical providers who administer the drug(s) in the outpatient setting will be reimbursed only for the administration under the member’s medical plan.