Learn more about PA
Or call Provider Services at 1-844-365-4385 (TTY: 711). We’re here for you 8 AM to 5 PM, Monday to Friday.
Electronic PA (ePA)
You need the right tools and technology to help our members. That’s why we’ve partnered with CoverMyMeds® and Surescripts to provide a new way to request a pharmacy PA with our ePA program.
With ePA, you can look forward to saving time with:
Less paperwork
Fewer phone calls and faxes
Quicker determinations
Safe and secure HIPAA-compliant submitted requests
Easy upload of clinical documents
Enroll now
Getting started with ePA is free and easy. You’ll need this info to enroll:
- BIN: 610591
- GRP: RX881G
- PCN: MCAIDADV
You can enroll two different ways:
Other ways to request PA
If you don’t want to enroll in ePA, you can request PA:
By phone
Call us at ${provider_services_phone}.
By fax
Check “PA request forms” in the next section to find the right form. Then, fax it with any supporting documentation for a medical necessity review to 1-888-601-8461.
PA Request forms
If you don’t see the right form in the list, you can use the Universal Petition for Medication Authorization (PDF). You may also need these forms:
Otherwise, check for the drug class or drug name that matches your needs:
Legal notices
CoverMyMeds is the property of CoverMyMeds LLC.