Medications covered by medical benefits that you administer
If you are administering medication to a member in your office or in an outpatient setting, we encourage you to take these steps:
|Step||Check member benefits and eligibility. Use a self-service technology like Online Services() or contact us.|
Determine whether authorization for the medication is required.
Refer to our Medical Utilization Management (MED UM) & Pharmacy Prior Authorization Policy (033) or our Medical Utilization Management (MED UM) Drug List (034).
Learn how to request prior authorization.
Federal Employee Program members
|Step||Perform the service and submit your claim.|