Dispensing Limits
What Are Dispensing Limits?
Dispensing limits are rules around the amount of a prescription drug you can fill at a pharmacy at one time. Limits are often based on the drug maker's research. Dispensing limits help encourage safe medication use as intended by the U.S. Food and Drug Administration.
You and your doctor may decide you need more of a drug than what the dispensing limit allows. In that case, you can still get the drug, but you may be responsible for the full cost of the drug based on your benefit plan.
Dispensing Limits Per Drug List
If you want to learn if your prescription drug has a dispensing limit, it's best to log in to your Blue Access for MembersSM account , click on the Pharmacy tab, and search for your medication. If it has a dispensing limit, it displays that information. But if you know the name of your plan's drug list, you can review dispensing limits without logging in to BAMSM:
- Metallic Drug List Dispensing Limits
- Basic Drug List Dispensing Limits
- Enhanced Drug List Dispensing Limits
- Balanced Drug List Dispensing Limits
- Performance Drug List Dispensing Limits
- Performance Select Drug List Dispensing Limits
Request Override For Dispensing Limit
If your drug request is not shown in the drug categories of the dispensing limits drug list, your doctor can use the Dispensing Limit Override Physician Fax Form . This form should be completed by the doctor who's prescribing the medication. The doctor then faxes the completed form to the Prime Therapeutics Clinical Review Department at 1-877-243-6930. If you have questions or need additional information, call 1-888-723-7443.