Language Assistance Available [pdf, 778 KB] Prescription Claim Form [pdf, 1406 KB] Prior Approval Form for Prescription Drugs [pdf, 50 KB]
2018 Standard Formulary [pdf, 1708 KB] 2018 Standard with Step Drug List [pdf, 1415 KB] 2018 Standard with Step Therapy Formulary [pdf, 1928 KB] Standard/Standard with Step 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 © 2002-2018 BlueAdvantage Administrators of Arkansas