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Prior Authorizations and Exceptions
(for Medication and Treatment)

Members

To request assistance with a prior authorization, please call:

Care1st Member Services
1-800-544-0088
TTY users should call: 711
From 8:00 a.m. to 8:00 p.m., seven days a week.


You may ask to obtain the aggregate numbers of the plan's grievances, appeals, and exceptions . Please contact Member Services at 1-800-544-0088 (TTY: 711)

Physicians

  • Physicians' Medication Prior Authorization Form
    The Physicians' Medication Prior Authorization Form is optional and not necessary to request a coverage determination. Prescribers can request a coverage determination by contacting our toll free number 1-877-792-2731, 24 hours a day, seven days a week.
  • Treatment Authorization Request
    The Physicians' Treatment Prior Authorization Form is optional and not necessary to request a coverage determination. Providers can request a coverage determination by contacting our toll free number 1-800-544-0088, 24 hours a day, seven days a week.
  • Special Medical Records Release Form
    Authorize the provider on this form to release a copy of your medical records
  • Part D Prior Authorization Information