Prior Authorization
05/02/2014
AETNA BETTER HEALTH OF ILLINOIS MEDICAID
Neulasta (IL88)
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Prior Authorization
08/26/2015
AETNA BETTER HEALTH OF ILLINOIS MEDICAID
Acamprosate (IL88)
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Reference Number: C7837-A / Effective Date: 12/01/2017
1
Pharmacy Prior Authorization
AETNA BETTER HEALTH ILLINOIS (MEDICAID)
IPF Agents (Medicaid)
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Practitioner Application Screening Form
PLEASE COMPLETE ONE FORM PER PRACTITIONER IN PRACTICE
Mail completed form to:
Aetna Better Health, 333 West Wacke
Change In Prior Authorization Requirements
Aetna Better Health of IL would like to notify you that effective January 1, 2019, Aetna Better
Health of IL, wil
Reference Number: C4911-A / Effective Date: 06/16/2017
1
Pharmacy Prior Authorization
AETNA BETTER HEALTH ILLINOIS (MEDICAID)
Aranesp (Medicaid)
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Prior Authorization
08/26/2015
AETNA BETTER HEALTH OF ILLINOIS MEDICAID
Non-Calcium Based Phosphate Binders (IL88)
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CVS is new pharmacy manager for Aetna Better Health of Illinois
