Prior Authorization Forms
Certain medications require prior authorization or medical necessity. To download a prior authorization form for a non-formulary medication, please click on the appropriate link below.
Please note that the form must be approved before medication can be dispensed.
Prior Authorization Forms for Non-Formulary Medications
- Actemra (tocilizumab)
- Addyi (filbanserin)
- Adempas
- Adlyxin, Byetta, Bydureon, Victoza
- Aimovig
- Ajovy
- Aklief (trifarotene)
- Altoprev
- Amitiza
- Amzeeq (minocycline)
- Androderm, AndroGel, Natesto, Testim, Testosterone 1.62% gel, & Vogelxo
- Anti-Obesity Agents
- Austedo
- Auvi-Q
- Baricitinib (Olumiant)
- Basaglar (insulin glargine), Semglee (insulin glargine-YFGN)
- Basal Insulin Analogs (Levemir and Levemir Flextouch)
- Belsomra, Dayvigo
- Belviq
- Benlysta (belimumab)
- Benzoyl Peroxide Products
- Bepreve (bepotastine), Emadine (emedastine), Lastacaft (alcaftadine)
- Braftovi
- Brand Name Over Generic
- Bremelanotide injection (Vyleesi)
- Breo Ellipta
- Brukinsa (zanubrutinib)
- Butrans (Buphrenorphine transdermal system)
- Bydureon, Bydureon BCise and Trulicity
- Bystolic
- Calquence (acalabrutinib)
- Cambia (diclofenac potassium powder packets)
- Caplyta (lumateperone)
- Cialis (Tadalafil)
- Cimzia (Certolizumab)
- Compounded Medications
- Continuous Glucose Monitor (CGM): Freestyle Libre 2 and Dexcom
- Contrave
- Copiktra
- Cordran (flurandrenolide)
- Corlanor (ivabradine)
- Cosentyx
- Cotempla XR ODT (methylphenidate)
- Cycloset (bromocriptine)
- Cequa (cyclosporine 0.09%), Restasis (cyclosporine 0.05% multi-dose), Xiidra (lifitegrast 5%) ophthalmic solution
- Darolutamide (Nubeqa)
- Denavir
- Diclegis
- Diflorasone diacetate
- Duexis and Vimovo
- Duloxetine DR capsules (Drizalma Sprinkle)
- Dupixent (dupilumab)
- Dutasteride (Avodart)
- Eluxadoline (Viberzi)
- Emgality 100mg
- Emgality 120mg
- Enstilar, Taclonex, Wynzora (calcipotriene-betamethasone)
- Entrectinib (Rozlytrek)
- Epidiolex
- Erleada
- Etanercept (Enbrel)
- Eucrisa
- Eysuvis (loteprednol)
- Fasenra
- Febuxostat (Uloric)
- Fedratinib (Inrebic)
- Ferric Maltol (Accrufer)
- Fertility Agents (Injectable Gonadotropins Only)
- Fetzima (levomilnacipran XR)
- Fibric Acid Derivatives
- Firdapse
- Fluticasone propionate 93 mcg nasal spray (Xhance)
- Forteo
- Fortesta (testosterone 2% topical gel)
- Gemtesa (vibegron)
- Gilenya (Fingolimod)
- Gocovri (amantadine ER)
- Gralise (gabapentin ER)
- Growth Hormone
- Hepatitis C Medications
- Hetlioz, Hetlioz LQ (tasimelteon)
- H.P. Acthar Gel
- Horizant (gabapentin enacarbil)
- Humira (adalimumab)
- Ibrance
- Ilumya
- Imbruvica
- Ingrezza
- Inhaled Corticosteroids (Aerospan, Alvesco, Arnuity Ellipta, Asmanex HFA, Asmanex Twisthaler, Pulmicort Flexhaler, QVAR, QVAR Redihaler)
- Inqovi (decitabine/ cedazuridine)
- Intrarosa (prasterone)
- Invokamet, Invokamet XR, Xigduo XR, and Segluromet
- Invokana, Farxiga, Steglatro, Inpefa, and Steglujan
- Istradefylline (Nourianz)
- Jalyn (Dutasteride/tamsulosin)
- Janumet (sitagliptin + metformin immediate-release) and Janumet XR (sitagliptin + metformin extended-release)
- Januvia (sitagliptin)
- Jatenzo, Kyzatrex, Tlando (testosterone undecanoate capsules)
- Jornay & Azstarys
- Jublia and Kerydin
- Jynarque (tolvaptan)
- Kalydeco (ivacaftor)
- Kapspargo
- Kazano, Jentadueto, Jentadueto XR, and Kombiglyze XR PA
- Kerendia (finerenone)
- Kevzara
- Kineret (anakinra)
- Letairis (ambrisentan), Opsumit (macitentan)
- Levorphanol (Levo-Dromoran)
- Linzess
- Liptruzet
- Lescol XL (fluvastatin extended-release), Livalo (pitavastatin), Zypitamag (pitavastatin magnesium)
- Lomaira
- Lonhala Magnair (glycopyrrolate)‎
- Lovaza
- Lumakras (sotorasib)
- Lynparza
- Lyrica and Lyrica CR (pregabalin)
- Mavenclad (cladribine)
- Mecasermin (Increlex)
- Mekinist
- Mektovi (binimetinib)
- Migraine Agents: Nasal Triptans (Zomig)
- Migraine Agents: Oral Triptans
- Minocycline ER, Ximino ER, Coremino ER, Minolira ER, Seysara
- Mounjaro (tirzepatide), Ozempic (semaglutide)
- Movantik
- Mydaysis
- Myrbetriq (mirabegron)
- Myrbetriq Granules (mirabegron)
- Namenda XR and Memantine ER
- Namzaric
- Nasal Allergy Drugs
- Nerlynx (neratinib)
- Neulasta, Ziextenzo, Nyvepria
- Neupogen (filgrastim), Zarxio (filgrastim-sndz)
- Neupro (rotigotine)
- Nesina, Oseni, Tradjenta, and Onglyza
- Newer Sedative Hypnotics (Ambien CR, Edluar, Intermezzo, Lunesta, Rozerem, Silenor, Zolpimist)
- Newly Approved Innovator Drugs
- Nexletol, Nexlizet
- Ninlaro (ixazomib)
- Nintedanib Esylate (Ofev)
- Nocdurna
- Noctiva
- Nucala (mepolizumab)
- Nucynta ER
- Nuplazid (pimavanserin)
- Nurtec ODT (rimegepant)
- Ocaliva
- Odactra (house dust mite allergen extract)
- Omnipod and Omnipod DASH
- Omnipod 5 kits and pods
- Opzelura (ruxolitinib)
- Oral Bisphosphonates (Actonel, Atelvia, Binosto, Fosamax Plus D)
- Orencia
- Orgovyx (relugolix)
- Oriahnn (elagolix/ estradiol/ norethindrone), Myfembree (relugolix/ estradiol/ norethindrone)
- Orkambi
- Otezla
- Detrol (tolterodine IR), Enablex (darifenacin), Gelnique (oxybutynin gel), Oxytrol (oxybutynin transdermal patch), Sanctura XR (trospium ER), Toviaz (fesoterodine), Vesicare (solifenacin)
- Oxervate
- Pennsaid
- Pexidartinib (Turalio)
- Pirfenidone (Esbriet)
- Pliaglis (lidocaine-tetracaine 7%-7%)
- Pomalyst
- Praluent
- Pramlintide (Symlin)
- Pristiq and Khedezla
- Proton Pump Inhibitors: Nexium, Aciphex, and generics
- Proton Pump Inhibitors: Prevacid ODT and Zegerid suspension
- Proton Pump Inhibitors: Prevacid, Zegerid, and generics
- Prucalopride (Motegrity)
- Qbrexza (glycopyrronium)
- Qelbree (viloxazine)
- Qsymia (phentermine/ topiramate ER)
- Qualaquin (quinine sulfate)
- Qudexy XR and Trokendi XR
- Qulipta (atogepant)
- Rapaflo (Silodosin)
- Rayos (prednisone DR)
- Relistor
- Renin Angiotensin Antihypertensive Agents (RAAs)
- Repatha (evolocumab)
- Revefenacin (Yupelri)
- Revlimid (lenalidomide)
- Rexulti
- Reyvow
- Rocklatan and Rhopressa
- Ryaltris (olopatadine HCl/ mometasone furoate)
- Rytary
- Safinamide (Xadago)
- Savella (milnacipran)
- Self-Monitoring Blood Glucose System (SMBGS) Glucose Test Strips
- Semaglutide oral tablet (Rybelsus)
- Simponi (Golimumab)
- Skyrizi (risankizumab) on-body injector
- Skyrizi (risankizumab) auto-injector & prefilled syringe
- Skytrofa (lonapegsomatropin-tcgd)
- Solaraze (diclofenac 3%)
- Soliqua
- Stelara (ustekinumab)
- Stendra (avanafil)
- Subcutaneous Immunoglobulins (SCIG)
- Sulfacetamide and Sulfacetamide Sodium/Sulfur
- Symbicort (budesonide/formoterol) and Dulera (mometasone/formoterol)
- Symdeko (tezacaftor-ivacaftor)
- Symproic
- Synjardy and Synjardy XR
- Tafinlar (dabrafenib)
- Taltz
- Tavalisse
- Tecfidera (dimethyl fumarate)
- Testosterone cypionate and enanthate
- Tetracyclines
- Tezspire (tezepelumab-ekko)
- Thiazolidinediones (TZDs, Actos, Actoplus Met, Actoplus Met XR, Duetact, Avandia, Avandament, and Avandaryl)
- Tiopronin IR / Tiopronin DR (Thiola / Thiola EC)
- Topical Acne and Rosacea Agents: Azelex and Finacea (azelaic acid)
- Topical Acne and Rosacea Agents: Dapsone Products
- Topical Acne and Rosacea Agents: Metronidazole Products
- Topical Acne and Rosacea Agents: Retinoids and Combinations
- Topical Acne and Rosacea Agents: Rhofade, Mirvaso and Soolantra
- Toujeo
- Tracleer (bosentan)
- Tremfya (guselkumab)
- Tresiba
- Trikafta (elexacaftor-tezacaftor-ivacaftor)
- Trintellix (vortioxetine)
- Trulance (plecanatide)
- Tymlos
- Tyrvaya (varenicline tartrate)
- Ubrogepant (Ubrelvy)
- Rinvoq (upadacitinib)
- USFHP Standard PA Form
- V-Go Disposable Insulin Delivery Device
- Vascepa
- Venclexta (venetoclax)
- Veozah (fezolinetant)
- Verzenio
- Viagra (Sildenafil)
- Vowst (fecal microbiota spores, live-brpk)
- Vytorin
- Vyvanse
- Vyzulta
- Wakix (pitolisant)
- Wegovy (semaglutide), Saxenda (liraglutide)
- Winlevi (clascoterone)
- Xalkori (crizotinib)
- Xeljanz and Xeljanz XR
- Xenical (orlistat)
- Xermelo
- Xifaxan 200mg
- Xifaxan 550mg
- Xolair (omalizumab) syringe
- Xpovio (selinexor)
- Xtandi (enzalutamide)
- Xultophy
- Xyosted (testosterone enanthate)
- Xyrem (sodium oxybate) & Xywav (calcium, potassium & sodium oxybate salts)
- Yonsa
- Zejula (niraparib)
- Zelboraf (vemurafenib)
- Zembrace Symtouch
- Zeposia (ozanimod)
- Zerviate (cetirizine)
- Zoryve (roflumilast 0.3%)
- Zytiga 250 mg (abiraterone)
- Zytiga 500 mg (abiraterone)