Upcoming pharmacy policy notifications

Learn about new pharmacy policies and revisions to current policy criteria here.

Prior authorization for a pharmacy benefit drug

To submit a prior authorization request for a pharmacy benefit drug, providers can visit CoverMyMeds

Note: Not all employer groups retain Prime Therapeutics as their pharmacy benefits manager (PBM). The pharmacy policies content only applies to those employer groups who retain Prime Therapeutics. Member ID cards with RxBIN 610455 and RxPCN PGIGN or HMHS on the front indicate that a member has Prime Therapeutics as their PBM and these pharmacy policies apply.