Medications Requiring Prior Authorization Under the Medical Benefit

We’ve made changes to the list of medications requiring prior authorization under the Medical Benefit. As part of our policy, Healthfirst requires prior authorization for medical claims for all medications listed in this document.

This applies to the following Healthfirst lines of business:

• Child Health Plus
• Essential Plan
• Leaf & Leaf Premier Plans
• Medicare
• Medicaid
• Personal Wellness Plan
• Pro EPO and Pro Plus EPO
• Small Business Plans
• Note: this does not impact Senior Health Partners.

Check back frequently to stay current on future changes.