BlueRx Limited Benefit Drugs

**NOTE: Prior approval for limited benefit drugs is only required if you have coverage under the BlueRx formulary. Members of a BlueRx plan will receive PBC Extended Health Care cards with the words BLUENET/BLUERX appearing on the bottom of the card. An example of the card is reproduced below:

If you are still not sure if your drug coverage is the BlueRx plan, contact your Plan Administrator or Pacific Blue Cross.

Choose the drug category

• Acne Therapy
• Appetite suppressants and anti-obesity agents
• Analgesics used for pain control
• Peptic ulcer therapy drugs
• Bio response modifiers for rheumatoid arthritis
• Bio response modifiers for Crohn's disease