Language Assistance Available [pdf, 561 KB] Prescription Claim Form [pdf, 823 KB] Prior Approval Form for Prescription Drugs [pdf, 50 KB]
2017 Standard Formulary [pdf, 1494 KB] 2017 Standard with Step Drug List [pdf, 1054 KB] 2017 Standard with Step Therapy Formulary [pdf, 1495 KB] 2018 Standard Formulary [pdf, 1477 KB] 2018 Standard with Step Drug List [pdf, 1188 KB] 2018 Standard with Step Therapy Formulary [pdf, 1516 KB] Prior Approval List [pdf, 149 KB] Medications that require prior approval. For authorization, call 1-877-433-2973.
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 © 2002-2017 BlueAdvantage Administrators of Arkansas