Prior Authorization Request Procedure
The Molina Healthcare Drug Formulary is a listing of preferred drug products eligible for reimbursement by Molina Healthcare. All medications are listed by generic name. The medications are organized by therapeutic classes. Prescriptions for medications requiring prior approval or for medications not included on the Molina Healthcare Drug Formulary may be approved when medically necessary and when Formulary alternatives have demonstrated ineffectiveness. When these exceptional needs arise, the physician may fax a completed "Prior Authorization / Medication Exception Request
" form to Molina Healthcare. The forms may be obtained by calling Molina Healthcare of Florida at (866) 472-4585
Items on this list will only be dispensed after prior authorization from Molina Healthcare.
Certain injectable and specialty medications require prior authorization
To find a Molina Healthcare participating pharmacy, please click on Find a Pharmacy.
J-Code Prior Authorization Update Effective 04/01/19
Adobe Acrobat Reader is required to view the file(s) above. Download a free version.