Authorization Forms To ensure that members receive the most appropriate and cost-effective drug therapy, some plans require that additional steps be taken before certain drugs are covered
Specialty Pharmacy Authorization Forms
Use this form for requesting a prior authorization for a medication on the specialty pharmacy list. Specialty pharmacy medications are used in treating rare and/or chronic diseases and are often targeted therapies. We have prior authorizations on some of these medications to ensure that the most appropriate patients are receiving them.
Exception Request Form
Use this form for requesting an exception when a drug authorization form is not available.