December 01, 2022

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.

Submitting requests

To submit a prior authorization or step therapy request:

  • Sign in to the UnitedHealthcare Provider Portal
  • Click on the Prior Authorization tool
  • 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.

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