Prior Authorization

The following prescription drugs require prior authorization. OptumRx will require physicians to complete a prior authorization form, specifying the intended use and length of use, for the medications below. These medications may need to go through the prior authorization process multiple times a year depending on the physician’s recommendations.

Prescription DrugOptumRx Prior Authorization Requirements
Prescriptions to treat Attention Deficit and Hyperactivity Disorder (ADHD)Requires prior authorization approval over age 19
Prescriptions to treat Acne Prior authorization may be required to ensure compliance with intended use
Compounded PrescriptionsPrior authorization may be required for compounded prescriptions that cost $200 or greater