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 members enrolled in an Anthem Colorado health plan: The Colorado Prescription Drug Prior Authorization Request form may be used to submit prior authorization requests for members enrolled in a Colorado health plan, regardless of residence. 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.
 
Attention prescribing providers with members enrolled in an Anthem New Hampshire plan: The New Hampshire Prescription Drug Uniform Prior Authorization Request Form may be used for all members enrolled in a New Hampshire plan, regardless of residence. NOTE, effective January 1, 2018, due to state law, the New Hampshire Prescription Drug Uniform Prior Authorization Request Form MUST be used, or we will not be able to review your request for authorization. The drug specific criteria and forms found within the (Searchable) lists on the Drug List Search tab are for informational purposes only to assist you in completing the New Hampshire Prescription Drug Uniform Prior Authorization Request Form if they are helpful to you. Please fill out the New Hampshire Prescription Drug Uniform Prior Authorization Request Form and fax it to (877) 327-8009.
 
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.
 
To our providers: Click here to initiate an electronic prior authorization (ePA) request.