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Medication Authorizations



All SWHP non-contracted provider requests for prior authorization of services or drugs obtained through the medical benefit are processed by Cigna. 

Please take the following steps to ensure your request is processed in a timely manner:

    • You MUST FIRST verify benefits and eligibility with SWHP by phone. Call 1-844-769-3994 and speak to a customer advocate.
    • When verification is complete, you may have the advocate transfer you directly to Cigna, OR you may contact Cigna at 1-866-494-4872 to determine prior authorization requirements and initiate prior authorization requests.


SWHP Medication Prior Authorizations and Exceptions

Here you can find medication prior authorization criteria. You can also find forms for medicines that require prior authorization.

SWHP Drug List Formularies

Prior Authorization Criteria

Step Therapy Criteria

Prior Authorization Request Forms - Drug Specific (Go to: Medicare Form)

Medicines: A - E

Medicines: F - M

Medicines: N - S

Medicines: T - Z

Prior Authorization Request Forms - General (Go to: Medicare Form)

SWHP ACA Compliant Formulary Prior Authorization Forms

Medicare Part D Prior Authorization Forms - Drug Specific

The following forms do NOT encompass all Part D drugs requiring prior authorization. If a drug-specific form is not listed below, please use the Medicare Coverage Determination Request Form below.

Medicare Part D Prior Authorization Forms – General