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Prior Authorization


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What is Prior Authorization?
Prior Authorization can be called many things: Formulary Override, Pre-Approval, Formulary Exception, "PA", etc. All of these terms refer to the process of obtaining approval for coverage of a medication from your health plan. Your health plan wants to ensure that the appropriateness and medical necessity of medications your physician has prescribed. All health plans establish formulary guidelines to help manage this process.
A patient can save hundreds of dollars a year on medication through prior authorization. Find how much you can save.
You need Prior Authorization when your medication is "NOT COVERED"
If your physician has prescribed a medication for you that is not covered by your health plan's formulary (list of covered drugs), a prior authorization request will allow you to get the prescribed medication at your usual co-payment amount rather that paying full price at the pharmacy.
Apricot Can Help
For over 10 years, the Apricot Prior Authorization Line (PAL) service has made it easier for physicians and patients to get medications that require prior authorization. If your medication is eligible, taking advantage of this process will save you money.
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