SubHero Banner

Electronic prior authorization (ePA) makes submitting PAs easier and more convenient. We've partnered with various ePA providers, including CoverMyMeds and Surescripts, making it easier for you to submit an ePA through the vendor of your choice.

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Submitting a prior authorization request via fax
If you cannot submit requests through ePA, or for urgent requests, please call us at 1-800-711-4555.
Hours: 5am PST to 10pm PST, Monday through Friday.

Otherwise, you can submit requests to the OptumRx® Prior Authorization Department by completing and faxing the applicable form (Medicare Part D, UnitedHealthcare, OptumRx®, and State Specific.)

Medicare Part D

Member's ID indicates Medicare Part D coverage


UnitedHealthcare (non-Medicare)

OptumRx indicated as the pharmacy benefit manager


OptumRx (non-Medicare)

Member belongs to an OptumRx pharmacy plan


State Specific PA forms

State specific prior authorization fax forms