Rx Prior Authorization
Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered by your benefits. This approval process is called prior authorization.
Drug list/Formulary inclusion does not infer a drug is a covered benefit. Please check your schedule of benefits for coverage information.
Attention prescribing providers with patients enrolled in a Colorado health plan: The Colorado Prescription Drug Prior Authorization Request form may now be used to submit prior authorization requests for members enrolled in a Colorado health plan. You may also choose to continue to use the drug specific forms which are provided below along with the drug specific criteria. Requests for prior authorization may also be submitted by phone by calling 866-310-3666 or through our secure electronic portal located at https://express-scripts.covermymeds.com/. To learn more about required Colorado timelines for decisions regarding prior authorization requests, please click here.
Select the Drug List Search tab to access up-to-date coverage information in your drug list, including – details about brands and generics, dosage/strength options, and information about prior authorization of your drug.