Language Assistance Available [pdf, 561 KB] Prescription Claim Form [pdf, 882 KB] Prior Authorization Form for Prescription Drugs [pdf, 127 KB]
2016 Standard Formulary [pdf, 1480 KB] 2016 Maintenance Drug List [pdf, 751 KB] 2016 Standard with Step Therapy Formulary (Formerly known as Value Formulary) [pdf, 1483 KB] Prior Authorization List [pdf, 611 KB] Medications that require prior approval. For authorization, call 1-877-433-2973.
Language Assistance Available
BlueAdvantage Administrators of Arkansas is an Independent Licensee of the Blue Cross and Blue
Shield Association and is licensed to offer health plans in all 75 counties of Arkansas.
Copyright © 2002-2016 BlueAdvantage Administrators of Arkansas