A compounded medicine is a blend of ingredients that the pharmacist prepares especially for you at your prescriber's request. To be covered under your pharmacy benefit, a compounded medicine must have at least one ingredient that is a prescription drug with an FDA-approved therapeutic indication.
If you are prescribed a compound medication, please call customer service at 877-224-3525 for help in locating a pharmacy equipped to compound your prescribed medication. If a compounding pharmacy can not be located in your area, customer service may be able to assist you in finding an alternative solution.
If you obtain your prescription at a non-network pharmacy and qualify for an exception, please use the Prescription Drug Reimbursement Form and mail this form and your receipts to:
Premera Blue Cross
P.O. Box 91059
Seattle, WA 98111-9159
Make sure your pharmacist lists all the VALID 11-digit NDC numbers and quantities for each ingredient on the back of the form.