Prior authorization may be required for the following drugs and reasons:
Prior authorization requests may be submitted by the member or the provider; however, supporting clinical information is usually needed from the provider.
Call us to request prior authorization:
1-833-422-4690 (TTY 1-877-454-8477)
Requests can be faxed to:
Members can download a request form and provide it to providers to complete to request a prior authorization.