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Medications Requiring Prior Authorization Under the Medical Benefit

Posted 8/28/2020 at 1:46 PM

Ensure you remain current on the most recent changes

We’ve made changes to the list of medications requiring prior authorization under the Medical Benefit. As part of our policy, Healthfirst requires prior authorization for medical claims for all medications listed in this document when administered in an office or clinic setting.

This applies to the following Healthfirst lines of business:

  • Child Health Plus
  • Essential Plan
  • Leaf & Leaf Premier Plans
  • Medicare
  • Medicaid
  • Personal Wellness Plan
  • Pro EPO Pro Plus EPO
  • Small Business Plans

    Note: this does not impact Senior Health Partners

Check back frequently to stay current on future changes.