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Insurance Plans - Georgia
Select the name of your insurance company to find out where to get forms
and to find contact information for your plan if you need to request prior
authorization or an exception.
This information was collected from the Web sites of the plans, and in
some cases from e-mails and phone calls to the plans. It is provided here
in an effort to make the information more conveniently available to you.
We do not endorse any particular plan and we are not responsible if any
plan has been inadvertently omitted from this list. We have not verified
this information. In addition, we cannot be responsible for ensuring that
the information is always up to date. Please notify
us if you are aware that any of the information provided has changed.
If you would like more detailed and current information, we suggest that
you consult the Medicare
Web site.
AETNA HEALTH INC
ANTHEM HEALTH PLANS OF KENTUCKY, INC.
BLUE CROSS BLUE SHIELD OF GEORGIA
Where to Get Forms: http://www.anthemprescription.com
Phone # to request Prior Authorization: 1-800-338-6180
Phone # to request Exception: 1-800-338-6180
Fax #: 1-800-601-4829
Fax #: Not Available Updated: May 2006
CONNECTICUT GENERAL LIFE INSURANCE COMPANY
COVENTRY HEALTH AND LIFE INS COMPANY
Where to Get Forms: Call 1-800-551-2694 and ask to have form faxed.
Phone # to request Prior Authorization: 1-800-551-2694
Phone # to request Exception: 1-800-551-2694
Fax #: Call 1-800-551-2694 and ask for fax number.
Fax #: Not Available
Updated: May 2006
HUMANA HEALTH PLAN, INC.
INSTIL HEALTH INSURANCE COMPANY
Where to Get Forms: Call 1-800-788-2949 and ask to have form sent.
Phone # to request Prior Authorization: 1-800-788-2949 Option 3
Phone # to request Exception: 1-800-788-2949 Option 3
Fax #: 858-790-7100
Fax #: customerservice@medimpact.com Updated: May 2006
KAISER FOUNDATION HP
Where to Get Forms: Call 1-877-645-1282 and ask for assistance.
Phone # to request Prior Authorization: Not Available
Phone # to request Exception: 1-877-645-1282
Fax #: Not Available
Fax #: janice.m.regan@kp.org Updated: May 2006
MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK
Where to Get Forms: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Prior Authorization: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Exception: Not Available
Fax #: Not Available
Fax #: Not Available
Updated: May 2006
MEMBERHEALTH, INC.
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
PENNSYLVANIA LIFE INSURANCE COMPANY
Where to Get Forms: Call 1-800-244-5800 and ask to have form sent.
Phone # to request Prior Authorization: 1-800-244-5800
Phone # to request Exception: 1-800-244-5800
Fax #: 513-881-6841
Fax #: JRoesch@pharmacare.com Updated: May 2006
QCC INS CO D/B/A AMERIHEALTH INS CO
RXAMERICA, LLC
Where to Get Forms:
Call 1-866-772-7737 for fax on demand automated phone service.
Phone # to request Prior Authorization: 1-866-549-0991
Phone # to request Exception: 1-866-549-0991
Fax #: 1-866-855-2676
Fax #: lois.mastin@rxamerica.com Updated: May 2006
SILVERSCRIPT INSURANCE COMPANY
STERLING LIFE INSURANCE COMPANY
Where to Get Forms: http://www.foxrxcare.com/exceptions.htm
Phone # to request Prior Authorization: 1-888-369-7979
Phone # to request Exception: 1-888-369-7979
Fax #: 1-866-284-4509
Fax #: Not Available Updated: May 2006
UNICARE
UNITED AMERICAN INSURANCE COMPANY
Where to Get Forms: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Prior Authorization: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Exception: Not Available
Fax #: Not Available
Fax #: pharmcontracting@medco.com Updated: May 2006
UNITED HEALTHCARE INSURANCE COMPANY
Where to Get Forms: Call 1-877-665-6620 and ask to have form faxed.
Phone # to request Prior Authorization: 1-877-665-6620
Phone # to request Exception: 1-800-207-2579
Fax #: 1-866-617-6696
Fax #: provider.relations@walgreens.com Updated: May 2006
WELLCARE HEALTH PLANS
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