Other PA options
If you’re unable to use ePA, there are other ways to submit your PA request.
Call us at 800.753.2851, download a state specific fax form or fax your requests to the number shown on our general request form. For example, use the prior authorization general request form below if you would like to request a coverage determination (such as a step therapy exception) or if you would like to make an appeal for us to reconsider a coverage decision.
- Visit this page for state specific forms and PA statistics
- Download Prior Authorization General Request Form (e.g., use this to initiate step therapy exception)
- Medicare Plan Members Coverage Review Information