Skip to main content

Pharmacy prior authorization

When a medication isn't listed on our formulary or has a utilization management requirement, you need to request pharmacy prior authorization. Take a minute to review our current guidelines.

Pharmacy prior authorization guidelines

Electronic prior authorization (ePA)

Electronic prior authorization (ePA)

At Aetna Better Health® of California, we make sure you have all 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 pharmacy prior authorization with our ePA program.

 

With ePA, you can look forward to saving time with:

 

  • Less prior authorization paperwork, phone calls and faxes
  • Quicker determinations
  • Safe and secure HIPAA-compliant submitted requests

Enroll now

 

Getting started is free and easy. There are two different ways you can enroll:

CoverMyMeds

You can enroll with CoverMyMeds online. Or give them a call at 1-866-452-5017.

Surescripts

You can enroll with Surescripts online. Or give them a call at 1-866-797-3239.

Other ways to request pharmacy prior authorization

 

If you don’t want to enroll in ePA, here are the ways you can request prior authorization:

Online

You can request prior authorization through our secure Provider Portal.

Visit portal

By phone

You can request prior authorization by calling us at 1-855-772-9076 (TTY: 711).

By fax

Download our pharmacy prior authorization form. Then, fax it to us with any supporting documentation for a medical necessity review.

 

Sacramento: 1-866-489-7441 

San Diego: 1-844-584-4450

For more information

Consult your provider manual or call us at 1-855-772-9076 (TTY: 711).