Priority Health no longer utilizes drug-specific prior authorization forms for most drugs covered under the pharmacy benefit.
Visit the Approved Drug List (ADL) to search by drug name and view the criteria and PA form.
Authorization formTraditional & Optimized
For further information on medical drugs, please see the Injectable drugs page.
Benefit: Pharmacy only, must be ordered from a specialty pharmacy
Notes: Treatment of rheumatoid arthritis, juvenile RA, ankylosing spondylosis, plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis