How to request drugs that are not on the Approved Drug List
If a prescribed drug is not on CalOptima’s Approved Drug List, it must get approved first by CalOptima. Your doctor or pharmacy must use a Prior Authorization request form. The pharmacy and your doctor work together to send it to CalOptima for review. All CalOptima network pharmacies and doctors have this form.
You can also ask us for approval. Call Customer Service or fill out the Online Drug Prior Authorization Request form (below). For details about pre-approvals, see your Member Handbook.