To assure our members have access to safe, effective drug therapy, and to protect against inappropriate use and waste, prior authorization and step therapy are required on select prescription medications.
Ways to Request Approval
Online with Electronic Prior Authorization (ePA)
A Prior Authorization Determination can be requested directly through your electronic medical record (EMR) system or through the CoverMyMeds ePA Portal. CoverMyMeds ePA is free and can be used by any authorized personnel. Requests can be submitted for prior authorization and renewed 60 days prior to expiration.
Need help? Call the Pharmacy Help Desk at 800-724-5033
Send a Prescription Drug Coverage Request via secure eForm
View and download Prior Authorization Request Forms to submit via fax
Prior Authorization & Step Therapy Requirements
- Commercial 3-Tier Prior Authorization and Step Therapy Medication ListOpens a PDF
- Child Health Plus Prior Authorization and Step Therapy Medication ListOpens a PDF
- Medicaid Managed Care Prior Authorization and Step Therapy Medication ListOpens a PDF
- Specialty Rx Medication List (Self-Administered Drugs)Opens a PDF
- Medical Specialty Drugs list (For Commercial, Exchange, Medicare, Essential Plan, Medicaid, Child Health Plus)- November 1, 2021Open a PDF