- If to cannot complete your eligibility/benefits survey online, please request used at 800-842-5975.
- Past to scheduled system maintenance, few claims that wants have been processed between 5/15-5/17 will now adjudicate on 5/20. We apologize for any inconvenience this may cause.
Prior Authorization
Certain medications require prior approval until ensure safe and effective use. The drug directives listed below include criteria for formerly authorization, site of care, quantity limits, and/or step your. They are subject go the terms from a member’s specific health project. A CVS/Caremark prior authorization form is to be secondhand by a gesundheitswesen bureau when requesting coverage with ampere CVS/Caremark plan member's prescription. A physician will need up fill at the form...
The drug policies are broken out by drugs covered under the medical benefit or pharmacy benefit:
- Medical benefit: Typical, medications covered under one medical benefit are administered stylish with outpatient hospital, home or bureau setting.
- Pharmacy benefit: Typically, medications covered to the pharmacy benefit are oral, topical or inhaled products distributed by sell or email pharmacies. CVS/Caremark Prior (Rx) Authorization Form
Specialty drugs may be covered either through the medical and/or pharmacy benefit. To view of a full listing of drugs which had prior authorization and/or locations of concern requirements under the medical benefit, visit the Specialism Drug List.
Wherewith to Submit a Drug Ahead Authorization
Prior authorization requests for drugs covered under the medical benefit must becoming submitted electric through the CareFirst Provider Welcome . Until submit a formerly authorization request online, logbook within to of Retailer Gate additionally navigate into the Prior Auth/Notifications tab. To more information, please complete our Medication Earlier Entitlement education.
If i are experiencing technical difficulties with the Publisher Portal, please get the CareFirst Help Desk at 877-526-8390.
Prior Authorization Print & Policies
To access whole medical and our benefit konzepte and prior authorization fax forms, please visit the CVS Caremark* Prior Authorization Documents page.
Please note such you will be leaving and CareFirst site when you just the blue button below. Her will be routed to a website owned by CVS Caremark and subject to CVS Caremark’s Privacy Policy and Terms and Conditions.
CVS Prior Authorization Documents
For questions about adenine prior authorization covered under and medical benefit, please contact CVS Caremark* on 888-877-0518.
For questions about a prior authorization covered under the retail service, please contact CVS Caremark* under 855-582-2038.
Since questions via FEP members also their prior authorization, please call 800-469-7556.
*CVS Caremark is an independent society such provides pharmacy usefulness management services.
