BCBS of TN

Researching insurance options can be difficult, especially if you or someone you know is suffering from addiction. Knowledgeable advisors are available with BCBST, and they can verify your coverage to find the best treatment for you. Call your insurance provider and ask an informed representative about the details of your individual plan.

About BCBS of Tennessee

Founded in 1945, Chattanooga-based BlueCross BlueShield of Tennessee (BCBST) is focused on serving its 3.5 million members, not only in the Volunteer State but across the country.

As of 2014, BCBST played a significant role in Tennessee’s economy, accounting for more than a quarter of all healthcare spending in the state. BCBST has six regional offices in Tennessee.

As the opioid crisis continues to impact communities across the state and around the country, BlueCross BlueShield of Tennessee is in the midst of implementing efforts to combat the misuse of prescription painkillers. The coverage changes include:

     A seven-day limit for short-acting opioid prescriptions issued to members who are receiving the drug for the first time.

     An enhanced prior authorization requirement for extended use of short-acting opioids. This will impact those who use more than 30 days’ worth of short-acting medication in a 90-day period.

     A lower threshold for morphine milligram equivalent dose, with authorization required for more than 120 milligrams of opioids per day.

     Removal of OxyContin from its list of covered drugs, to be replaced with painkiller drugs that are less likely to be abused.

     Drug combination safety alerts for clinical teams and healthcare providers, highlighting inappropriate and dangerous combinations.

     Coverage of certain types of alternative pain therapy.

BlueCross leaders developed these changes with input from a statewide panel of independent medical experts, including public health officials and practicing clinicians. BCBS of Tennessee will approve prior authorization requests for members with cancer, or those receiving palliative or end-of-life treatment. These changes do not apply to Medicare Advantage and TennCare members.

BCBS of Tennessee announced it as removing OxyContin from its list of covered drugs in September 2016. The shift came as a blow to one of the drugs that ignited the nationwide opioid epidemic. In place of OxyContin, doctors are encouraged to prescribe two other painkillers: Xtampza and Morphabond. These drugs, often described as “abuse-deterrent” medication, are generally more expensive than OxyContin, but members have the same copay.

BlueCross leaders emphasize that these changes were developed and implemented gradually, so as to minimize disruption for members already taking these drugs.

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