Your pharmacy benefits are coordinated through Express Scripts, a company that provides Premera members access to high quality prescription medications programs.
Some prescription medications are part of Express Scripts' Prior Authorization program. These medications include:
If you have a new prescription or need a refill on certain existing prescriptions, your pharmacist will submit the prescription to Express Scripts to determine whether it meets the program requirements.
If your prescription drug therapy meets the requirements your prescription will be covered.
If it does not meet the requirements your provider will need to contact Express Scripts to request a prior authorization. Express Scripts will review the information from your doctor and make a decision regarding coverage of your drug therapy. The review takes one to two business days and you will receive a letter in the mail explaining the decision. Your prescription is eligible for coverage as soon as an approval decision is made.