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Prior Authorization

Prior authorizations are controls on your formulary that help figure out if the medicine your doctor prescribed is safe, medically effective and the most appropriate way to treat your condition.

CVS/caremark will respond within 24–48 hours after receiving the prior authorization request from your doctor. You can also call CVS Customer Care at 1-866-889-0471 for more information.

If CVS/caremark denies your request for prior authorization, you can purchase the drug at your own expense. You or your doctor may also file an appeal for a denied medication. For additional information, call CVS/caremark at 1-866-889-0471. The costs for non-covered medications do not apply to your deductible or coinsurance. PCA funds may not be used for reimbursement.

You may be required to follow a process called step therapy. Learn more about that process on the step therapy page.

 

 

Questions about your benefits? Visit the Contact Us page for contact information on each vendor.