Prior authorization for coverage

What is prior authorization?

If you need a certain medication or dose, your doctor may need to contact us to request prior authorization for coverage. That means we must authorize coverage for the prescription under your prescription drug plan.

You can find out if prior authorization is required for your prescription by asking your doctor or checking the CIGNA HealthCare prescription drug list. Your pre-enrollment materials may also include a list of drugs that require prior authorization.

Prior-authorization guidelines are determined on a drug-by-drug basis and may be based on FDA and manufacturer guidelines, medical literature, safety, appropriate use and benefit design.

How to get prior authorization for your prescription

If your doctor prescribes a drug that requires prior authorization for coverage, ask your doctor to call the number on your CIGNA HealthCare ID card to begin the authorization process. Your doctor's office must complete the appropriate prior- authorization form or call us at the number on your CIGNA HealthCare ID card to provide the necessary information.