ExchangePrior AuthMedium impact
Update to Pharmacy Benefit Drug Prior Authorization Process for Exchange Members
BlueCross BlueShield of South Carolina·SC·Prior Authorization
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
Beginning April 1, 2026, BlueCross BlueShield of South Carolina will internally manage non-specialty drug prior authorization requests for Exchange members (group numbers starting with 61, 62, or 65), replacing OptumRx. Providers must use CoverMyMeds portal, phone, or fax for all pharmacy PA requests for these members.
Action Required
By April 1, 2026: All staff handling pharmacy prior authorizations must register for CoverMyMeds accounts and update workflows to use the new submission methods (CoverMyMeds portal preferred, phone 1-833-494-2987, or fax 1-803-462-5000) for Exchange members with group numbers starting with 61, 62, or 65. Stop using OptumRx for these members' pharmacy PA requests to avoid processing delays.