Approved Drug List
Electronic prior authorization
Downloads
Some drugs may require your provider to fill out an authorization form.
- Medicare prior authorization criteria
- Medicare step therapy criteria
- Request for Medicare Part D coverage determination
- Medicare Part B vs Medicare Part D coverage determination form
- Hospice/Part D drug prior authorization request
Drugs covered under the medical benefit
- Medical Benefit Drug List (MBDL) (formerly the Injectable Drug List)
- Medicare Part B drug request
- Medicare Part B oncology drug request
Medical drug-specific forms are linked in the Medical Benefit Drug List.
Learn how to request a drug redetermination (appeal).