Prior Authorization

There are three options for submitting a prior authorization form:

1. Submit the prior authorization electronically through CoverMyMeds which is Health Net's preferred way to receive prior authorization requests.
2. Complete the Prescription Drug Prior Authorization or Step Therapy Exception Request Form (PDF) and submit to Pharmacy Services.
3. Contact Pharmacy Services directly via telephone.

When certain designated injectables are requested by a participating provider, prior authorization must be obtained through Pharmacy Services. The only injectable medications that require prior authorization are self-injectable medications and a few specific injectable medications.

The participating provider must complete the Prescription Drug Prior Authorization or Step Therapy Exception Request Form (PDF) detailing the medical necessity and the duration of the requested medication. The completed form must be faxed to Pharmacy Services or the participating provider may telephone Pharmacy Services directly for urgent requests.

The approval or request for additional information is faxed back to the original requestor as noted on the form. Upon approval, Pharmacy Services forwards the authorization to one of Health Net's participating specialty pharmacy providers. The specialty provider contacts the Health Net member to arrange for delivery.