Medical specialty and pharmacy policies

Prior authorization information

Medications obtained through the medical benefit

Most medications covered on the medical benefit require prior authorization through Novologix (NLX). Click here for a list of the medications authorized by NovoLogix*.
 
For all other medical benefit medications, including those that are new-to-market, request authorization through AllWays Health Partners.
 
_{*Please note: This list is not inclusive of all medications that require prior authorization by AllWays Health Partners. This list is specific to medications reviewed by NLX only.}

Medications obtained through the pharmacy benefit

For medications covered on the pharmacy benefit, please submit prior authorizations through CVS Caremark using the information below.
 
To find out if a medication requires prior authorization or if it is listed on our formulary* please search the drug look up tool.
 
_{*Please note: Medications not listed in the drug look up tool are considered non-formulary and require a medical necessity prior authorization for coverage.}

Site of care – home infusion policy

Medical specialty and pharmacy drug policies