DialClerk Directory

Healthfirst

Pharmacy and drug authorizations

Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.

pharmacy prior auth

Medical-benefit drug prior authorization (provider-administered drugs)

Official page read
Phone888-801-1660Fax

212-801-3223

Medical-benefit drug authorization requests only.

Published hours

Monday–Friday, 8:30am–5:30pm

Product, plan and location

Confirm the exact product or service
New York

Mailing address

Not researched for this route

Medications under the medical benefit: submit through Availity (Outpatient > Outpatient Pharmacy), by phone through Provider Services, or by fax. The manual says NOT to use this fax for pharmacy-benefit authorizations handled by CVS Caremark.

View source ↗ · Source checked 2026-10-24

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

pharmacy prior auth

Medicare Part D coverage determinations — CVS Caremark (Healthfirst Medicare)

Official page read
Phone855-344-0930Fax

855-633-7673

Published hours

Phone 7am–6pm CST Monday–Friday; fax 24/7

Product, plan and location

medicare part d · medicare advantage
New York

Mailing address
CVS Caremark Part D Services Attention: Prior Authorization – Part D MC109 P.O. Box 52000 Phoenix, AZ 85072-2000

Written Part D coverage determination requests.

Part D pharmacy-benefit prior authorization / coverage determinations for Healthfirst Medicare members, handled by CVS Caremark. Online via CoverMyMeds (Caremark).

View source ↗ · Source checked 2026-10-24

Report an update
Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

pharmacy prior auth

Pharmacy coverage determinations — CVS Caremark (Healthfirst Child Health Plus)

Official page read
Phone877-433-7643Fax

866-848-5088

Published hours

8:00am–6:00pm CST

Product, plan and location

chip
New York

Mailing address

Not researched for this route

Pharmacy-benefit prior authorization / formulary exceptions for Healthfirst CHPlus members via CVS Caremark. Medicaid pharmacy is carved out to NYRx and is not handled here.

View source ↗ · Source checked 2026-10-24

Report an update
Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

pharmacy prior auth

Pharmacy coverage determinations — CVS Caremark (Healthfirst Leaf / Leaf Premier plans)

Official page read
Phone800-294-5979Fax

866-836-0730

Published hours

8:00am–6:00pm CST

Product, plan and location

exchange
New York

Mailing address

Not researched for this route

Pharmacy-benefit prior authorization for Healthfirst Leaf and Leaf Premier (Qualified Health Plan) members via CVS Caremark.

View source ↗ · Source checked 2026-10-24

Report an update
Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

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Call preparation · editorial guide

Make the call count.

Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.

Have ready in your secure workspace

  • PBM name and the pharmacy identifiers on the card
  • Drug, formulation and prescription information
  • Prescriber details and previous review reference

Questions to resolve

  • Is this processed under the medical or pharmacy benefit?
  • What is the correct review and submission channel?
  • Is there a separate specialty pharmacy or appeal team?

This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.

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