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Xiidra - Lifitegrast solution/ Drops
Blue Cross and Blue Shield of Massachusetts
Blue Cross and Blue Shield of Massachusetts Coverage for Xiidra - Lifitegrast solution/ Drops
All
6
Commercial
4
Health Exchange
1
Medicare
1
Commercial
Commercial - PPO
PA Required
No Step Therapy
Quantity Limit
See Details
Commercial - Point of Service
PA Required
No Step Therapy
Quantity Limit
See Details
Commercial - HMO
PA Required
No Step Therapy
Quantity Limit
See Details
Commercial - Employer
No PA
No Step Therapy
No Quantity Limit
See Details
Health Exchange
Health Exchange - HMO - Health Insurance Exchange
PA Required
No Step Therapy
Quantity Limit
See Details
Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
See Details