If RegenceCare has a record of covering the non-formulary drug, the pharmacist can simply call RegenceCare to adjust the copay. You may request a Prescription Drug Preauthorization form from RegenceCare to initiate this process. Before you go to the pharmacy, ask your provider if the prescribed drug is in the formulary. All of our participating providers are issued an in-depth formulary that lists the drugs we cover. Certain maintenance medications listed on the RegenceCare Maintenance Medication List will be available to a maximum of 100 tablets or capsules or a one-month supply, whichever is greater, for your pharmacy copay.
Some prescription drugs require prior authorization before they can be covered.
Shown below are the drugs that currently require prior authorization. Prescription drugs obtained through PPS will be provided in full after you have paid the copay specified below. It is intended to provide information on health care and other issues of interest to Public Employees and Retirees on Regence BlueShield and RegenceCare plans. Regence BlueShield is a nonprofit health plan operating under the rules and regulations of the state of Washington. Any benefit information represents a summary of coverage provisions.