Pharmacy Resources and Physician Administered Drugs
Find pharmacy information related to prescription drugs including prescription drug lists, step therapy, quantity limits and prior authorization requirements for Community Plan care providers.
Pharmacy Benefit Manager Changes
On July 1, 2021, we will work with a new Pharmacy Benefits Manager, MedImpact.
All prior authorizations will be managed by MedImpact.
Pharmacy Prior Authorization:
Prescribers can submit requests:
• Online: Care providers can submit prior authorization requests online through Cover My Meds, Surescripts, or CenterX ePA portals.
• Fax: They can fax completed prior authorization forms to 858-357-2612 beginning July 1, 2021.
• Phone: Call 844-336-2676 from 8 a.m. to 7 p.m., Monday through Friday, Eastern Time.
For all medically billed drug (Jcode) PA requests, please continue to send those directly to the United Healthcare for review.
Effective January 1, 2021, the Kentucky Department for Medicaid Services (DMS) requires UnitedHealthcare Community Plan to follow the Kentucky Fee-For-Service PDL and Clinical Criteria. Additional pharmacy benefit and medication information can be found below in this section to assist our providers.