Quantity limits are in place to ensure your medication is being used correctly and that you are getting the most appropriate treatment.^*

• Some prescriptions are limited to a specified maximum quantity. Amounts over that quantity are not covered unless approved in advance by the plan.
• Blue MedicareRx covers up to a 30-day supply for retail prescriptions, or up to a 90-day supply at certain retail pharmacies or through mail order.
• Drugs on the specialty tier are limited to a maximum 30-day supply.

No special steps are required to have your drugs covered, provided your medications are prescribed within specified limitations.

• If you require drugs in a larger quantity than is allowed, your physician may request a coverage exception.
• This type of exception is processed through a coverage determination.

• Request coverage of a quantity in excess of plan quantity limits with the Quantity Limit Exception Fax Form.
• Use the Coverage and Pricing Tool to find out if your prescription drug has a prior authorization requirement.