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  • Non-formulary Medication Prior Authorization Form

Get Non-formulary Medication Prior Authorization Form

NONFORMULARY MEDICATION PRIOR AUTHORIZATION FORM Please fax completed form to COVENTRY HEALTH CARE OF FLORIDA PHARMACEUTICAL SERVICES This fax machine is located in a secure location as required by.

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How to fill out the NON-FORMULARY MEDICATION PRIOR AUTHORIZATION FORM online

Completing the NON-FORMULARY MEDICATION PRIOR AUTHORIZATION FORM is essential for patients needing medications not listed on their insurance formulary. This guide will provide clear, step-by-step instructions to help users fill out the form effectively and submit it online.

Follow the steps to complete the form accurately.

  1. Click the ‘Get Form’ button to access the NON-FORMULARY MEDICATION PRIOR AUTHORIZATION FORM in the online editor.
  2. Enter the patient information in the designated fields, including the patient’s name, member ID number, and date of birth.
  3. Fill out the physician information section with the requesting physician’s name, specialty, office fax number, office phone number, office contact name, and office address.
  4. Provide the requested drug information, including the drug name, strength, dosing frequency, expected length of therapy, and quantity.
  5. Indicate the date of request and answer the questions regarding the patient's diagnosis, medication trials, and any contraindications, providing detailed explanations as needed.
  6. If applicable, check 'Yes' or 'No' for each question regarding reauthorization, prior medication trials, and clinical efficacy.
  7. In the additional comments section, provide any further required information that may support the authorization request.
  8. Obtain the prescriber’s signature and date after completing the form. Ensure all information is accurate.
  9. After completing the form, save your changes, download or print the form as needed, and then fax it to Coventry Health Care of Florida at 1-877-215-4100.

Take action now and start filling out the NON-FORMULARY MEDICATION PRIOR AUTHORIZATION FORM online to ensure timely submission.

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If a medication is “non-formulary,” it means it is not included on the insurance company's “formulary” or list of covered medications. A medication may not be on the formulary because an alternative is proven to be just as effective and safe but less costly.

Meaning. Non-formulary/Non-covered. Non-Formulary Drugs are not covered on the formulary drug list. An exception may be requested and is subject to review by the plan and is based on Pharmacy policy. Prior Authorization.

NON-FORMULARY EXCEPTION CRITERIA FOR APPROVAL The member must have tried at least three alternative formulary medications that have a similar mechanism of action as the requested medication AND the member either did not respond to or did not tolerate the formulary alternative medications.

An exception procedure can be used by prescribers and patients to request coverage for drugs that are not included on a plan's drug formulary. Through this administrative process, a plan can agree to cover medically necessary nonformulary drugs on a case-by-case basis.

If you need a drug that is not on your health plan's formulary, you must get your plan's approval or pay for the drug yourself. Your doctor should ask the plan for approval. In certain cases, a health plan may be required to cover a drug that is not on your plan's formulary.

Non-formulary medicines. Medicines for physical health problems. Use of medicines outside the terms of their marketing authorisation. Use of medicines without a marketing authorisation. Liquid or orodispersible formulations.

NON-FORMULARY EXCEPTION CRITERIA FOR APPROVAL The member must have tried at least three alternative formulary medications that have a similar mechanism of action as the requested medication AND the member either did not respond to or did not tolerate the formulary alternative medications.

A formulary is a list of generic and brand name prescription drugs covered by your health plan. Non-formulary drugs typically only include brand-name medications and come with high out-of-pocket expenses. Your health plan may only help you pay for the drugs listed on its formulary.

If a medication is “non-formulary,” it means it is not included on the insurance company's “formulary” or list of covered medications. A medication may not be on the formulary because an alternative is proven to be just as effective and safe but less costly.

Often, non-formulary drug request forms are used to request a nonformulary drug. The form should contain the patient basic information, the rationale of use, the volume of drugs needed.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232