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PHARMACY COVERAGE GUIDELINES SECTION: DRUGSORIGINAL EFFECTIVE DATE: LAST REVIEW DATE: LAST CRITERIA REVISION DATE: ARCHIVE DATE:1/01/16 9/20/18 9/20/18POMALYST (thalidomide) oral capsule Coverage
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To fill out Pomalyst-Blue Cross, follow the steps below:
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Obtain the Pomalyst prescription from your doctor.
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Contact Blue Cross to ensure that Pomalyst is covered by your insurance plan.
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Gather all necessary documents such as your insurance card and prescription information.
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Visit the Blue Cross website or call their customer service to find the specific form for Pomalyst.
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Fill out the form with accurate personal and prescription details.
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Double-check all the information provided to avoid any errors.
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Submit the filled-out form to Blue Cross through their preferred method, which may include online submission or mailing.
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Wait for Blue Cross to process your request and provide any necessary approvals.
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Once approved, you will be notified by Blue Cross about the next steps, such as the delivery of the medication or further instructions.
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Follow any additional instructions provided by Blue Cross or your healthcare provider to ensure a smooth and timely process.

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Pomalyst-Blue Cross is typically prescribed for individuals who meet the following criteria:
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It is important to consult with your healthcare provider and insurance provider to determine if you meet the specific requirements for Pomalyst-Blue Cross coverage.
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Pomalyst - Blue Cross is a prescription medication used to treat certain types of cancer.
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