Prior Authorization Criteria
For some drugs, you or your provider needs to get approval from Commonwealth Care Alliance before we will agree to cover the drug for you. Sometimes the requirement for getting approval in advance helps guide appropriate use of certain drugs. If you do not get this approval, your drug might not be covered by the plan. These documents provide a list of drugs that require prior authorization:
- Download the 2017 Prior Authorization Criteria (pdf)
To view the PDF files above, you may need to download a free copy of Adobe® Acrobat Reader software on your computer. (This link takes you away from the Commonwealth Care Alliance website pages.) Click here for more information about Adobe Acrobat.
*When you click this link, you will leave Commonwealth Care Alliance’s website.
Last Updated 05/01/2017