My medication needs approval before my plan will cover it (also known as prior authorization or PA). What do I need to do to get it covered?

Ask your doctor’s office to contact AffirmedRx so we can start the coverage review process. They know how the review process works and will take care of everything for you. AffirmedRx will review information your doctor provides to make sure you meet coverage guidelines for the medication. AffirmedRx will let you and your doctor know within 72 hours of the decision. If you meet the coverage guidelines, you’ll be approved for coverage of the medication. If you don’t meet the coverage guidelines, you and your doctor can appeal the decision. We’ll send you information either way.