Illinois: Prior authorization and step therapy changes
Optum to manage prescription medication prior authorization and step therapy requests
Eﬀective Feb. 1, 2023, Optum®, an aﬃliate of Golden Rule Insurance, will manage prior authorization and step therapy requests for prescription medications that are subject to review under the OptumRx® Pharmacy Utilization Management (UM) Program. This change applies to residents who have medical pharmacy coverage in the state of Illinois.
To submit a prior authorization or step therapy request:
Select Create a new notification or prior authorization request
Enter the required information on the submission site
To support our review, clinical requirements will be documented within the request submission. You can also attach medical records, if requested.
Access the OptumRx Pharmacy website for tools and resources. For information about the new process or for answers to speciﬁc questions, call Optum at 888-397-8129, 8 a.m.–5 p.m. local time, Monday–Friday.