This article was originally published by ERS. It is being published here for the convenience of UHD employees.
Did you know that your pharmacy benefits manager may ask your doctor for a rationale for your prescription medication? Like many other prescription drug plans, the HealthSelect Prescription Drug Program requires prior authorizations (PAs) for certain medications.
PAs require your doctor to explain why they are prescribing a specific medication. The prescription drug plan relies on the doctor’s explanation to ensure the medication qualifies for coverage under your pharmacy benefit. PAs are an effective way to help control misuse and protect patient safety to ensure the best possible therapeutic outcome.
In most cases, your pharmacy will inform you and your doctor of your medication’s need for a PA. If you learn your medication does need a PA, simply confirm with your doctor and ask them to contact OptumRx, the administrator of the HealthSelect Prescription Drug Program. Or you can always call OptumRx to help get you started. Once OptumRx reviews the information from your doctor, you and your doctor will receive a letter to let you know if the medication is approved or denied for coverage and any next steps you can take.
To learn more about the PA process or how to find out if your medication needs a PA, check out Prior Authorization under Education Resources on www.HealthSelectRx.com.