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RDTP staff pharmacists are available for assistance with prior authorization requests by calling (800) 847-3859. Agents with prior authorization criteria are listed below.
Emergency medical services UniCare does not require prior authorization for treatment of emergency medical conditions.
Prior authorization is required for certain Medicaid services and supplies, like home-based care or durable medical equipment (DME).
Apply for Medicaid in West Virginia Apply through HealthCare.gov or by calling 1-800-318-2596 (24 hours a day). Eligibility: The aged, blind, and disabled. Also, adults with incomes up to 138% of FPL; children with household incomes up to 300% of FPL are eligible CHIP; pregnant women with incomes up to 158% of FPL.
The purpose for this authorization is to determine a physical or mental condition, illness, or disability and the right, if any, to retirement, reinstatement, or other benefits under the Public Employees Retirement Law (PERL) (Government Code sections 20000, et seq.)
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People also ask

Who is eligible for West Virginia Medicaid? Household Size*Maximum Income Level (Per Year)1$19,3922$26,2283$33,0644$39,9004 more rows
ALL Out-of-Network services requested for WV Medicaid members require prior authorization by the Utilization Management Contractor (UMC) or the Bureau for Medical Services (BMS) before services are provided.
Unless the person requesting the record specifically requests a paper copy, the records can be delivered in electronic or digital form and the per page fee cannot exceed 20 cents per page, not to exceed $150 inclusive of all fees, except for applicable taxes.

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