Pharmacy and drug authorizations

Current Evernorth page reached from express-scripts.com/pa publishes this number for verbal prior authorization when electronic PA cannot be used. Telephone hours are not stated on the current page. The current linked general request form separately publishes fax 877-251-5896 and an urgent-request number; state-specific and plan-specific instructions may apply.

The current official Medicare coverage page links this form. Page 1 still prints 800-935-6103; page 3 prints fax 877-251-5896 and the Medicare Reviews address. The parent page instead lists 844-374-7377 for initial clinical coverage reviews. Both published telephone routes are preserved with their source-specific scope; no supersession is inferred. The old fax 877-328-9799 is not confirmed by these current sources. PDF metadata is December 2025, not a declared effective date.

The current PA page publishes this contact under $0 Copay Preventive Prescriptions — Affordable Care Act for reviewing an alternative qualifying medication. The linked Benefit Coverage Request form is printed LEPG427 01/2016 and contains broader historical instructions; the route is scoped to the current linking-page use. No medication coverage or no-cost eligibility is inferred.

The currently linked general request form prints this telephone specifically for an urgent request and this fax for the completed form. It states that standard criteria may not apply to all patients and some plans or situations need additional information. This is an administrative PA route. The PDF contains older revision text and metadata, disclosed in source provenance; the parent page currently links it.

Use for a coverage decision about a restriction on a specific medication. The page lists this phone; the currently linked coverage-determination form instead prints 800-935-6103, retained in a separate form-specific route. The sources agree on the fax and mail address. TTY 800-716-3231 is separately labeled.