We are committed to providing appropriate, high-quality, and cost-effective drug therapy to all Ambetter members. Use our Preferred Drug List to find more information on the drugs that Ambetter covers.
- Prior Authorization Request Form for Non-Specialty Drugs (PDF)
- Prior Authorization Request Forms for Specialty Drugs
- For Medical “J-Code” or “buy-and-bill” prior authorization requests, please submit the request through our secure Provider Portal.