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Prior Authorization Forms. PA Forms for Physicians. When a PA is needed for a prescription, the member will be asked to have the physician or authorized agent of the physician contact our Prior Authorization Department to answer criteria questions to determine coverage.
Print Plan Forms Download a form to start a new mail order prescription. To manage your prescriptions, sign in or register
Find a pharmacy now. Ready to get started? Manage your prescription plan online. Refill your mail order prescription in three simple steps. Jump to a specific topic. Getting started. Coverage and plan details. Prescription costs and savings. Getting your medication. Easy, secure refills. Getting started. New here? Let's get started.
A CVS/Caremark prior authorization form is to be used by a medical office when requesting coverage for a CVS/Caremark plan member’s prescription. A physician will need to fill in the form with the patient’s medical information and submit it to CVS/Caremark for assessment.
COVERAGE CRITERIA. The requested drug will be covered with prior authorization when the following criteria are met: • The requested drug will be used with a reduced calorie diet and increased physical activity to reduce excess body weight and maintain weight reduction long term.
PA Request Criteria. This fax machine is located in a secure location as required by HIPAA regulations. Fax complete signed and dated forms to CVS/Caremark at . Please contact CVS/Caremark at 1-888-413-2723 with questions regarding the prior authorization process.
Rx delivery by mail from CVS Caremark. Because your safety is more important than ever, we can deliver medications you take regularly in 90-day supplies. It’s contactless, there’s no delivery fee, and you’ll probably save money, too. Learn More.