Drug authorization & billing

Search our online formulary tool or drug- and plan-specific information on drug coverage, including prior authorization, step therapy requirements and quantity limits,

Drugs covered under the medical benefit

Reference the Medical Benefit Drug List (MBDL) (formerly the Injectable Drug List) to view coverage details for medications that are covered under the medical benefit. Forms for drugs that require authorization are linked in the MBDL.

Medical Benefit Drug List (MBDL)

Drugs covered under the pharmacy benefit

Coverage for medication and any applicable utilization management criteria can be found on the Approved Drug Lists. Since coverage and criteria differ by plan, choose the plan type to view the correct plan-approved drug list.

General drug request forms

Fax completed forms to Priority Health at 877.974.4411.

Use these general forms when there is no drug-specific form listed.

Medicare forms

MyPriority and Commercial forms

Resources