CommercialCoverageMedium impact
Gepants
Blue Cross & Blue Shield of Mississippi·MS · Neurology, Family Medicine, Internal Medicine +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
BCBS Mississippi updated their gepants policy to classify all four CGRP migraine medications (Nurtec ODT, Qulipta, Ubrelvy, and Zavzpret) as not medically necessary for both acute treatment and prevention of migraines, citing availability of covered alternatives. The policy expanded from previously covering two of these medications to now excluding all four gepants.
Action Required
Immediately: Billing team must verify formulary coverage for all gepant prescriptions (Nurtec ODT, Qulipta, Ubrelvy, Zavzpret) using patient member ID before submission. For State Health Plan members, check formulary at https://www.dfa.ms.gov/cvs-caremark and submit prior authorization requests to pharmacy benefit manager. Claims for these medications will likely be denied as not medically necessary.