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  • () Injectable Medication Precertification Request. ()

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( ) Injectable Medication Precertification Request Aetna Precertification Notification 503 Sunport Lane, Orlando, FL 32809 Phone: 1-866-503-0857 FAX: 1-888-267-3277 Page 1 of 2.

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Getting approval for tests, procedures and more helps Aetna ensure that any care you receive is backed by the latest medical evidence.

What is a specialty drug? Specialty drugs treat complex, chronic conditions. A nurse or pharmacist will often support their use during treatment. These drugs may be injected, infused or taken by mouth.

We will make a decision within 5 business days, or 72 hours for urgent care. If we deny your service, we will explain why in the letter. If we deny a service, you or your provider, with your written permission, can file an appeal.

Call the Aetna Pharmacy Precertification Unit: NonSpecialty 1-800-294-5979 (TTY: 711) or Specialty 1-866-814-5506 (TTY: 711).

We will make a decision within 5 business days, or 72 hours for urgent care.

Aetna partners with Novologix to offer free electronic prior authorization services for specialty drugs on Aetna's National Precertification List. You can use this service for commercial and Medicare members for all health plans.

inj, , Inj., Natpara, , , , and are currently listed on the Aetna Formulary Exclusions List. Therefore, these drugs are excluded from coverage for members enrolled in prescription drug benefits plans that use a closed formulary, unless a medical exception is granted.

Aetna®, CVS Pharmacy® and CVS Specialty® are part of the CVS Health family of companies. Prices for specialty pharmacy services are established by Aetna affiliates and may exceed Aetna's cost for these services.

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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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