For Generations Medicare Advantage plans, please call (844) 449-0360 orclick here for Coverage Determination and Prior Authorization forms.
PRESCRIPTION DRUG PRIOR AUTHORIZATION AND FORMULARY EXCEPTIONS
For Generations Medicare Advantage plans, click here.
Prior authorization (PA) and step therapy (ST) requirements encourage safe, cost-effective medication use by allowing coverage when certain conditions are met. GlobalHealth benefits require covered medications to be prescribed in adherence to FDA-approved and manufacturer-recommended indications, strength, dosage, treatment duration, etc.
When possible, submit prior authorization requests prior to treatment.
A member or member’s representative may request a prior authorization to be initiated. Members can contact GlobalHealth’s Customer Care at 877-280-5600 for assistance or select from the below forms to provide to their physician. The prescribing physician will be required to complete the form and submit additional documentation such as clinical notes, lab values, etc. that support your prior authorization request.
Select a drug from the list below:
Effective January 1, 2023, GlobalHealth’s Commercial membership will be migrated to the Provider Portal, previously rolled out in January 2022 for our Medicare Advantage membership. GlobalLink™ will continue to be available for a limited time to access historical information from 2022 and earlier; however, any information for 2023 eligibility, claims, referrals, etc., will be accessed in the Portal.