Express Scripts Prior Authorization

▼   What is a coverage review or prior authorization?
USA Health & Dental Plan uses coverage management programs to help ensure you receive the prescription drugs you need at a reasonable cost. Coverage management programs include prior authorization,step therapy and quantity duration. Each program is administered by Express Scripts to determine whether your use of certain medications meets your plan’s conditions of coverage. In some cases, a coverage review may be necessary to determine whether a prescription can be covered under your plan.

If your prescription requires prior authorization, you or your doctor can initiate the prior authorization review by calling Express Scripts at 1-800-753-2851. Express Scripts will inform you and your doctor in writing of the coverage decision.
▼   Can I find out ahead of time if a medication may need a coverage review?
Yes, you can log on to www.Express-Scripts.com and use the “Price a Medication” feature. After you look up a medication’s name, click “View coverage notes.” Or you can call customer service at 855-687-3857.