We prescribe the kind of care you deserve.
It is important to have the right medications available when you need them. At , we carefully monitor the effectiveness of new drugs, constantly evaluate our formulary lists and strive to make our prescription benefit effective and affordable.
The Pharmacy Department is responsible for overseeing the proper administration of the pharmacy benefit for members.
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Prior Authorization Form
This form is to be used by participating physicians and pharmacies to obtain a medication that is not on the Formulary or requires prior authorization.
Download the Prior Authorization Form
For any questions regarding your prescriptions or our Medication Formulary, please call Member Services:
8 a.m. to 6 p.m., Monday through Friday
TTY: 711 – hours same as above
Pharmacy Department Phone: (877) 792-2731
Fax: (866) 712-2731 or (323) 889-6254