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Washington prior authorization form

Wa molina medication 2026

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The document is a prior authorization and medication exception request form for Molina Healthcare of Washington. It includes sections for patient and physician information, medication details, medical justification, and pharmacy contact information. The form emphasizes the need for generic medications unless specified otherwise and outlines processing times and confidentiality notices.

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Click ‘Get Form’ to open the wa molina medication request in the editor.
Begin by entering the patient's name, member ID, and date of birth in the designated fields. Ensure accuracy for seamless processing.
Fill in the physician's name and specialty, along with their contact information including phone and fax numbers.
Specify the medication details: name, strength, dose, quantity per month, and directions for use. This information is crucial for approval.
Provide a diagnosis or medical indication that justifies the medication request. Include any previous medications tried along with their usage dates.
Indicate if this is a re-authorization of current medication and include the pharmacy's fax number to ensure prompt communication.
Add any additional comments or notes that may assist in processing your request effectively.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Does Washington Medicaid cover prescriptions?

Yes. Apple Health (Medicaid) pays for drugs that are preferred on the Apple Health Preferred Drug List. What is a preferred drug list? A preferred drug list (PDL) is a list of drugs that Apple Health will pay for, usually without prior authorization.

Does Molina Healthcare cover CVS?

Prescription drugs are covered by Molina Healthcare, via our pharmacy vendor, CVS Caremark. A list of in-network pharmacies is available on the molinaheathcare.com website, or by contacting Molina Healthcare. Members must use their Molina Healthcare ID card to get prescriptions filled.

Does Molina insurance cover prescriptions?

(Please do not pay for the prescription.) Prescriptions are covered through Molina Healthcares contracted pharmacies within your service area. Prescriptions are covered outside of service area for emergency or urgent services only. You need an interpreter to communicate with the pharmacy about getting your medication.

Does Molina Healthcare cover Adderall?

Molina Healthcare covers Adderall for patients with a confirmed diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) or narcolepsy by a qualified healthcare provider.

How do I know if my insurance will cover a prescription?

Call your insurer directly to find out what is covered. Have your plan information available. The number is available on your insurance card the insurers website, or the detailed plan description in your Marketplace account. Review any coverage materials that your plan mailed to you.

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Does Molina cover prescriptions?

Prescriptions are covered through Molina Healthcares contracted pharmacies within your service area. Prescriptions are covered outside of service area for emergency or urgent services only. You need an interpreter to communicate with the pharmacy about getting your medication.

How to get Molina to cover Ozempic?

Work with your healthcare provider to submit a prior authorization request if Molina Healthcare requires one for Ozempic. Ensure all necessary documentation, such as medical history and justification for using Ozempic, is included in the submission.

What kind of insurance covers prescriptions?

Nearly all health plans cover medically necessary prescription drugs. Health plans usually have a list of drugs they have already approved for coverage. This list is called a formulary. Health plans often place drugs into different drug tiers on the formulary.