Medications that Require Prior Authorization
Medications requiring prior authorization are noted in the Health Tradition Formulary.
For a list of exclusions in addition to the Complete Formulary, please reference Health Tradition Drug Exclusions.
Please note:
- We do not cover any drug that has not been approved by the FDA for at least one (1) year for the purpose that your healthcare provider is prescribing it or it is otherwise being used.
- We do not cover any weight loss medication.
- We do not cover any infertility medication.
Our Customer Service Team can help with questions on whether a medication requires prior authorization. Practitioners are responsible for submitting prior authorizations.
For prescriptions requiring prior authorization, the standard authorization time is 72 business hours. Expedited reviews will be processed in 24 hours. When documentation of prior use of a drug is provided, a drug that requires prior authorization would be approved as a continuation of therapy.