Some medicines need a preapproval, or an OK from us, before your doctor can prescribe them. Drugs that require preapproval will be listed with PA next to the drug name. For those medicines, your doctor must submit a preapproval request before you can fill your prescription. Your doctor can call Provider Services at 800-454-3730 or fax the form to 844-487-9292.
Drugs that require preapproval include those that:
- Can have high side effect potential
- Should be prescribed only for specific usage
- Have a high misuse or abuse potential
- May cost more than other preferred drugs
The preapproval process helps us make sure you’re taking medicines safely and correctly.
Other times you may need preapproval are:
- When requesting a higher dosage than recommended
- When the drug is part of a step therapy treatment plan
- When requesting a brand-name drug that already has an FDA-approved generic version
If your doctor recommends a drug that isn’t on our formulary, you may request an exception by emailing us at submitmyexceptionreq@Wellpoint.com. You’ll be asked to give a reason why it should be covered.