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  • Aimovig Prior Authorization Request Form (page 1 Of 2)

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OptumRx has partnered with CoverMyMeds to receive prior authorization requests, saving you time and often delivering realtime determinations. Visit go.covermymeds.com/OptumRx to begin using this free.

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Your patient's health plan may require a PA for Aimovig®. This checklist may help you organize specific information about your patient's diagnosis and treatment history to complete an Aimovig® PA.

The cost for Aimovig subcutaneous solution (aooe 70 mg/mL) is around $786 for a supply of 1 milliliter(s), depending on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans.

Do Medicare prescription drug plans cover Aimovig? Yes. 74% of Medicare prescription drug plans cover this drug.

AIMOVIG is indicated for the preventive treatment of migraine in adults. The recommended dosage of AIMOVIG is 70 mg injected subcutaneously once monthly.

AIMOVIG was discontinued in most reported cases of constipation with serious complications. Constipation was one of the most common (up to 3%) adverse reactions reported in clinical studies [see Adverse Reactions (6.1)].

Aimovig can be prescribed in-person or through telemedicine, by primary care doctors and neurologists.

Aimovig is a brand-name prescription drug that's FDA-approved to prevent migraine headaches in adults. Aimovig can be used to prevent both episodic and chronic migraine headaches.

In clinical studies of Aimovig, up to 50% of people with episodic migraine who received 140 mg of the drug reduced their migraine days by at least half over 6 months. About 40% of people who received 70 mg saw similar results.

If approved by the patient's health plan to take Aimovig® (erenumab-aooe), a patient pays as little as a $5 copay per month, up to an annual maximum benefit. This applies to patient out-of-pocket costs, including deductible, co-insurance, and copayments for Aimovig®.

Renewal requests for Aimovig (erenumab) may be approved when the following criteria are met: I. Individual has a reduction in the overall number of migraine days or reduction in number of severe migraine days per month; AND II. Individual has obtained clinical benefit deemed significant by individual or prescriber.

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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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