Medicaid

This information applies to Medicaid members who have Medicaid prescription drug benefits. Prime Therapeutics is the Pharmacy Benefit Manager (PBM) that provides drug benefits through Blue Cross and Blue Shield of New Mexico (BCBSNM).

Drug List

Forms

Prior Authorization

Physicians can access, complete, and submit prior authorization and step therapy request forms electronically from the CoverMyMeds® website.

Prescription Exception Requests

Providers may submit coverage exception requests by fax to 1-877-243-6930, by phone at 1-800-285-9426 (TTY/TDD 711), or electronically on MyPrime.com Learn more about third-party links or CoverMyMeds® website Learn more about third-party links Providers can find forms on MyPrime.com Learn more about third-party links

Specialty Pharmacy Program

Refer to Pharmacy Services in the Turquoise Care section of the Blues Provider Reference Manual for a description of the Specialty Pharmacy Program, preauthorization requirements, and additional specialty services.

Related Resources:

Such services are funded in part with the State of New Mexico.