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Download a Drug Authorization form

Updated

  1. On the Navigation Bar, select Coverage and then Check Coverage.

  2. In the Explore by Category section, select Drug (Prescription).

  3. In the Plan member drop-down menu, select Plan Member.

  4. In the Drug name field, enter the drug you are looking for.

  5. Select Search.

  6. Find the medication you are looking for and select View Details.

  7. On the Exception Drug Requires Authorization screen, select Access Form.

  8. On the ProviderConnect page that appears, enter the name of the drug you are looking for and select Search.

  9. Select Download.