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However, in many instances, you may obtain a pre-determination of medical benefits by calling the Aetna member services phone number printed on the front of your Aetna ID card. Aetna will confirm the pre-determination of medical benefits in writing to you.
For requests for drugs on the Aetna Specialty Drug List, call 1-866-752-7021 (TTY: 711) or go to our Forms for Health Care Professionals page and scroll down to the Specialty Pharmacy Precertification (Commercial) drop-down menu.
Prior authorization is used to help plan providers ensure that their members are not being prescribed the most costly medication, until less expensive alternatives have been pursued. This cost check helps keep overall plan costs down and allows employers to continue offering drug benefits.
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