Your prescription may be processed by any pharmacy within our family of Express Scripts mail-order pharmacies. Express-Scripts uses data from Medi-Span to determine the average wholesale price of …

Prior Authorization criteria is available upon request. If you can't submit a request via telephone, please use our general request form or one of the state specific forms below and fax it to the number on the …

This form is based on Express Scripts standard criteria and may not be applicable to all patients; certain plans and situations may require additional information beyond what is specifically requested.

Based upon each patient’s prescription plan, additional questions may be required to complete the prior authorization process. If you have any questions about the process or required information, please …

Log in to your Express Scripts account to manage your prescriptions, order a refill, price a medication or view claim status.

A coverage review (also called prior authorization) simply means that more information is needed to see if your plan covers a medication. This review makes sure you’re getting a medication that is …

Ask your doctor to either call Express Scripts to request a coverage review or to prescribe an alternative medication that’s covered by your plan. After Express Scripts receives a prior authorization request, …

Use this form to ask your doctor to write your prescription for up to a 90-day supply or the maximum days allowed by your plan with refills of up to one year, if appropriate. Home Delivery Order Form - …

What if I need a coverage review (prior authorization) for a home delivery medication? If you ordered a prescription through home delivery and a coverage review is needed, Express Scripts Pharmacy will …

Nov 3, 2025 · Prior authorization is also sometimes called a coverage review. Your plan uses this review to help control costs and to make sure the medication is an effective treatment.