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Prior Authorization Criteria & Forms

Prior Authorization is only needed for certain drugs. If your plan's drug list (Formulary) indicates that you need a Prior Authorization for a specific drug, your health care provider must submit a prior authorization request form for approval.

If the request is not approved, please remember that you always have the option to purchase the drug at your own expense.

Find In-Network Doctors

If you need to find a new doctor who participates in one of our networks, our Doctor & Hospital finder makes it easy to find a health care professional who matches your needs.

Find In-Network Pharmacies

Search from more than 66,000 in-network pharmacies at Prime Therapeutics.

Find Covered Prescription Drugs

Find formulary drugs, prior authorization, and step therapy at Prime Therapeutics.