CommercialCoverageHigh impact
Pharmacy Updates
Blue Cross Blue Shield of Vermont·VT · Family Medicine, Internal Medicine, Cardiology +9 more·Prior Authorization
Effective date
Jul 1, 2026
We identified it
Jun 19, 2026
Summary
Effective July 1, 2026, multiple prescription drugs are moving to excluded status due to generic availability or requiring alternative products, while new prior authorization, quantity limits, and step therapy requirements are being added for specific medications across Blue Cross VT formularies.
Action Required
By July 1, 2026: Billing team must update prior authorization requirements for Arbli suspension, Depen tablets, and Lopressor solution in billing system. Update quantity limit controls for albendazole, Biltricide, Emverm, Esbriet, ivermectin, Leqembi, Ofev, sodium hyaluronate products, Stromectol, Votrient, and Xdemvy. Add step therapy requirements for Auryxia, Dymista, Nuvaring, Spiriva, Tiglutik, and Zoryve. Train staff on excluded drug alternatives and inform providers that claims for excluded medications will be denied without using specified alternatives.