Another group or vendor provides the info on the next page. If you don’t want to leave our site, choose the “X” in the upper right corner to close this message. Or choose “Go on” to move forward.
Pharmacy prior authorization (PA)
When a medication isn't on our Supplemental formulary or has a utilization management requirement, you’ll want to request pharmacy PA. Take a minute to review our current guidelines.
Electronic PA (ePA)
Electronic PA (ePA)
You need the right tools and technology to help our members. That’s why we’ve partnered with CoverMyMeds® and Surescripts to provide a new way to request a pharmacy PA with our ePA program.
With ePA, you can look forward to saving time with:
Less paperwork
Fewer phone calls and faxes
Quicker determinations
Safe and secure HIPAA-compliant submitted requests
Enroll now
Getting started with ePA is free and easy. You’ll need this info to enroll:
- BIN: 610591
- GRP: RX8829
- PCN: ADV
You can enroll two different ways:
Other ways to request PA
If you don’t want to enroll in ePA, you can request PA:
By phone
You can request PA by calling us at 1-855-232-3596 (TTY: 711).
By fax
Check “Request forms” to find the right form. Then, fax it with any supporting documentation for a medical necessity review to 1-855-296-0323.
Request forms
If you don’t see the right form in the list, you can use the universal pharmacy PA request form (PDF) Otherwise, check for the drug class or drug name that matches your needs:
Other ways to request PA
If you don’t want to enroll in ePA, you can request PA:
By phone
You can request PA by calling us at 1-855-232-3596 (TTY: 711).
By fax
Check “Request forms” to find the right form. Then, fax it with any supporting documentation for a medical necessity review to 1-855-296-0323.