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Pharmacy and drug authorizations
Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.
Organizations
111 organizations
Search departments by phone, fax or email → · Search individual lab, pharmacy and health-center locations →
Aetna (CVS Health)
Health plans and insurers · 5 organization contact routes
pharmacy help desk · pharmacy prior auth
Alexion OneSource
Medicine manufacturers and support programs · 2 organization contact routes
pharmacy help desk
Alnylam Assist
Medicine manufacturers and support programs · 1 organization contact route
pharmacy help desk
AlohaCare
Health plans and insurers · 2 organization contact routes
pharmacy prior auth · pharmacy help desk
Arkansas Medicaid (DHS / Gainwell)
Medicare and Medicaid · 1 organization contact route
pharmacy help desk
Baylor Scott & White Health Plan
Health plans and insurers · 3 organization contact routes
pharmacy help desk
Biogen Patient Support Services
Medicine manufacturers and support programs · 1 organization contact route
pharmacy help desk
Blue Cross and Blue Shield of Kansas City (Blue KC)
Health plans and insurers · 1 organization contact route
pharmacy help desk
Blue Cross and Blue Shield of Nebraska
Health plans and insurers · 1 organization contact route
pharmacy prior auth
Blue Cross and Blue Shield of North Carolina
Health plans and insurers · 1 organization contact route
pharmacy prior auth
CalOptima Health
Health plans and insurers · 5 organization contact routes
pharmacy prior auth · pharmacy help desk
Centene (Ambetter / Wellcare)
Health plans and insurers · 16 organization contact routes
pharmacy help desk · pharmacy prior auth
CHAMPVA (VA Health Administration Center)
Medicare and Medicaid · 1 organization contact route
pharmacy help desk
Costco Pharmacy (mail order and specialty)
Pharmacies · 1 organization contact route
pharmacy help desk
CoverMyMeds (McKesson)
Other healthcare organizations · 1 organization contact route
pharmacy help desk
CVS Caremark
Pharmacy benefit managers · 11 organization contact routes
pharmacy prior auth · pharmacy help desk
Delaware Medical Assistance Program (DMAP)
Medicare and Medicaid · 1 organization contact route
pharmacy help desk
Denver Health Medical Plan
Health plans and insurers · 1 organization contact route
pharmacy help desk
Eastern Oregon Coordinated Care Organization
Health plans and insurers · 1 organization contact route
pharmacy help desk
Eisai Patient Support
Medicine manufacturers and support programs · 1 organization contact route
pharmacy help desk
Elevance Health / Anthem
Health plans and insurers · 4 organization contact routes
pharmacy help desk · pharmacy prior auth
ELIQUIS 360 Support — Bristol Myers Squibb and Pfizer
Medicine manufacturers and support programs · 1 organization contact route
pharmacy help desk
Elixir Solutions (Elixir Rx)
Pharmacy benefit managers · 3 organization contact routes
pharmacy help desk · pharmacy prior auth
Excellus BlueCross BlueShield
Health plans and insurers · 1 organization contact route
pharmacy prior auth
Express Scripts TRICARE Pharmacy
Health plans and insurers · 3 organization contact routes
pharmacy prior auth · pharmacy help desk
First Choice by Select Health of South Carolina
Health plans and insurers · 1 organization contact route
pharmacy help desk
Health Care Service Corporation (HCSC) - BCBS IL/TX/OK/NM/MT
Health plans and insurers · 2 organization contact routes
pharmacy help desk
Health First Colorado (Colorado HCPF)
Medicare and Medicaid · 1 organization contact route
pharmacy help desk
Health Net (California)
Health plans and insurers · 5 organization contact routes
pharmacy help desk · pharmacy prior auth
Heart of America Medical Center
Hospitals and health systems · 1 organization contact route
pharmacy help desk
Humana
Health plans and insurers · 4 organization contact routes
pharmacy prior auth · pharmacy help desk
Ionis Every Step
Medicine manufacturers and support programs · 5 organization contact routes
pharmacy help desk
Judi Rx (formerly Capital Rx)
Pharmacy benefit managers · 1 organization contact route
pharmacy prior auth
Kaiser Permanente
Health plans and insurers · 8 organization contact routes
pharmacy prior auth · pharmacy help desk
Kroger Prescription Plans / Kroger Specialty Pharmacy
Pharmacies · 8 organization contact routes
pharmacy help desk
KVK Tech — Lomaira and generic products
Medicine manufacturers and support programs · 1 organization contact route
pharmacy help desk
Liberty Mutual (workers compensation)
Health plans and insurers · 1 organization contact route
pharmacy help desk
LifeWise Health Plan of Washington
Health plans and insurers · 1 organization contact route
pharmacy help desk
Louisiana Blue (Blue Cross and Blue Shield of Louisiana)
Health plans and insurers · 1 organization contact route
pharmacy prior auth
Louisiana Medicaid (LDH / Gainwell)
Medicare and Medicaid · 1 organization contact route
pharmacy help desk
Magellan Rx Medicare (Prime Therapeutics)
Pharmacy benefit managers · 1 organization contact route
pharmacy prior auth
Medicare GLP-1 Bridge — CMS
Medicare and Medicaid · 2 organization contact routes
pharmacy prior auth · pharmacy help desk
Mississippi Division of Medicaid (Gainwell)
Medicare and Medicaid · 1 organization contact route
pharmacy help desk
Missouri HealthNet (MO HealthNet Division / Wipro)
Medicare and Medicaid · 1 organization contact route
pharmacy help desk
Montana Healthcare Programs (Medicaid, Conduent)
Medicare and Medicaid · 2 organization contact routes
pharmacy prior auth · pharmacy help desk
New Mexico Medicaid (HCA / Turquoise Care)
Medicare and Medicaid · 1 organization contact route
pharmacy help desk
Norton Sound Health Corporation
Hospitals and health systems · 1 organization contact route
pharmacy help desk
Optum Specialty / Optum Specialty Pharmacy
Pharmacies · 3 organization contact routes
pharmacy help desk
OptumRx
Pharmacy benefit managers · 7 organization contact routes
pharmacy prior auth · pharmacy help desk
Oregon Health Plan (OHA Medicaid fee-for-service)
Medicare and Medicaid · 1 organization contact route
pharmacy help desk
PacificSource Health Plans
Health plans and insurers · 1 organization contact route
pharmacy help desk
Presbyterian Health Plan (New Mexico)
Health plans and insurers · 2 organization contact routes
pharmacy help desk
Prime Therapeutics
Pharmacy benefit managers · 4 organization contact routes
pharmacy prior auth · pharmacy help desk
Rightway Healthcare (PBM)
Pharmacy benefit managers · 2 organization contact routes
pharmacy help desk
South Country Health Alliance
Health plans and insurers · 3 organization contact routes
pharmacy prior auth · pharmacy help desk
Teva Total Support
Medicine manufacturers and support programs · 1 organization contact route
pharmacy help desk
The Hartford (workers compensation)
Health plans and insurers · 1 organization contact route
pharmacy help desk
UCB Patient Support Programs
Medicine manufacturers and support programs · 2 organization contact routes
pharmacy help desk
UnitedHealthcare
Health plans and insurers · 6 organization contact routes
pharmacy prior auth · pharmacy help desk
Vermont Medicaid (DVHA / Gainwell)
Medicare and Medicaid · 1 organization contact route
pharmacy prior auth
Walgreens Specialty Pharmacy (formerly AllianceRx Walgreens)
Pharmacies · 4 organization contact routes
pharmacy help desk
WellDyne
Pharmacy benefit managers · 2 organization contact routes
pharmacy prior auth · pharmacy help desk
Wellmark Blue Cross and Blue Shield
Health plans and insurers · 1 organization contact route
pharmacy help desk
West Virginia Medicaid (BMS / Gainwell)
Medicare and Medicaid · 1 organization contact route
pharmacy help desk
Wyoming Medicaid (Dept of Health)
Medicare and Medicaid · 2 organization contact routes
pharmacy help desk · pharmacy prior auth
No organizations match. Try a shorter name or another department.
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.
For the people making the calls
Put payer follow-up
on your office’s worklist.
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A request does not create an account or start a call. Use business contact information only. No patient information.