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Electronic prior authorization (ePA)
through CoverMyMeds

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Submit via fax using a form below.

Prescribers can submit requests to the OptumRx® prior authorization department by completing the applicable drug-specific form when available and faxing it to 1-800-527-0531.

For urgent requests, call 1-855-297-2870.

Hours:
5 a.m. PST to 10 p.m. PST, Monday through Friday
6 a.m. PST to 3 p.m. PST, Saturday

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A-Z drug-specific forms

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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Other Forms