Pharmacy Services
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HMO and PPO
Providers must contact Pharmacy Services and complete the Prescription Drug Prior Authorization or Step Therapy Exception Request Form (PDF) to request prior authorization for certain prescription medications before medications are dispensed.
Prior authorization type | Fax | Phone | |
Pharmacy and self-injectable requests (Pharmacy Services) | 866-399-0929 | 800-548-5524, option 2 | MedPharm Attention: Prior Authorization 4191 East Commerce Way Sacramento, CA 95834-9679 Mailstop: CA4151-04-530 |
Physician-administered medications (Pharmacy Services) | 844-235-5090 | 800-867-6564, option 2 | MedPharm Attention: Prior Authorization 4191 East Commerce Way Sacramento, CA 95834-9679 Mailstop: CA4151-04-530 |
Medi-Cal
Providers must contact Pharmacy Services and complete the Prescription Drug Prior Authorization or Step Therapy Exception Request Form (Health Net (PDF), CalViva Health (PDF), Community Health Plan of Imperial Valley (PDF)) to request prior authorization for certain prescription medications before medications are dispensed. Pharmacy Services is responsible for review of requests for medical benefit medication prior authorization for Health Net Medi-Cal members.
Prior authorization type | Fax | Phone | |
Physician-administered medication requests (Pharmacy Services) | 833-953-3436 | 800-867-6564, option 2 | MedPharm Attention: Prior Authorization 4191 East Commerce Way Sacramento, CA 95834-9679 Mailstop: CA4151-04-530 |
Medicare Advantage HMO
Providers can submit prior authorization electronically through CoverMyMeds (preferred), submit the Prescription Drug Prior Authorization or Step Therapy Exception Request Form (PDF) or contact Pharmacy Services to request prior authorization for certain prescription medications.
Contact | Fax | Phone | |
Pharmacy Services | 800-977-8226 | 800-867-6564, option 1 | MedPharm Attention: Prior Authorization 4191 East Commerce Way Sacramento, CA 95834-9679 Mailstop: CA4151-04-530 |