Prior Authorization

Not all drugs in a medication class will be subject to prior authorization. Certain medication classes require pre-authorization prior to fill. They are:

  • Androgens and Anabolic Steroids (PA)
  • Anorexiants
  • Cystic fibrosis
  • Dermatologicals — Tretinoins/Tazorac (all dosage forms)
  • Hepatitis
  • Bone conditions
  • Oncology medications
  • Smoking deterrents
  • Fentanyl
  • Asthma/COPD

Note: Additional medications may require pre-authorization prior to fill.

If you use pain (narcotic) or sleep disorder medications and the dosage prescribed exceeds FDA-approved levels, your prescription will be subject to prior authorization. This precaution is designed to address safety concerns with these drugs.

If you are prescribed an oral cancer medication, genetic testing at no charge to you may be offered to confirm you will metabolize the drug properly and to ensure no resistance or immunity to the drug. In addition, pre-authorization will confirm the drug use is aligned with FDA approvals and is being properly administered.