Prior Authorization Guides by Payer
How to write a Letter of Medical Necessity and appeal denials at every major US health plan and PBM.
Aetna
Commercial · 22M+
UHC
Commercial · 27M+
Cigna
Commercial · 17M+
Humana
Medicare · 17M+
BCBS
Commercial · 115M+
Anthem
Commercial · 47M+
Kaiser
Commercial · 12M+
Medicare D
Medicare · 50M+
Medicare B
Medicare · 60M+
Medicaid
Medicaid · 90M+
Caremark
PBM · 90M+
ESI
PBM · 100M+
OptumRx
PBM · 65M+
Molina
Medicaid · 5M+
Centene
Medicaid · 26M+
TRICARE
Commercial · 9.6M+
VA
Commercial · 9M+
Highmark
Regional · 6M+
Horizon
Regional · 3.5M+
BCBSIL
Regional · 8M+
Elevance
Commercial · 47M+
Wellpoint
Medicare · 4M+
WellCare
Medicare · 4.4M+
Ambetter
Commercial · 5M+
Oscar
Commercial · 1.6M+
Healthfirst
Medicaid · 1.8M+
CareSource
Medicaid · 2M+
AmeriHealth Caritas
Medicaid · 2M+
Magellan Rx
PBM · 28M+
Prime
PBM · 38M+
MedImpact
PBM · 55M+
Navitus
PBM · 11M+
EmblemHealth
Regional · 3M+
IBX
Regional · 2.5M+
UPMC
Regional · 4M+
HealthPartners
Regional · 1.8M+
Point32
Regional · 2.2M+
AvMed
Regional · 0.3M+
Premera
Regional · 2.3M+
Regence
Regional · 3.3M+
CareFirst
Regional · 3.5M+
SCAN
Medicare · 0.3M+
Devoted
Medicare · 0.3M+
Alignment
Medicare · 0.2M+
Clover
Medicare · 0.08M+
Florida Blue
Commercial · 5.5M+
Blue Shield CA
Commercial · 4.5M+
Blue Cross NC
Commercial · 4M+
BCBS MI
Commercial · 4.5M+
BCBS FEP
Commercial · 5.6M+
UHC Community Plan
Medicaid · 10M+
Aetna Better Health
Medicaid · 2.5M+
Health Net
Medicaid · 3M+
Fidelis Care
Medicaid · 2M+
L.A. Care
Medicaid · 2.5M+
Priority Health
Commercial · 1.2M+
SelectHealth
Commercial · 1M+
GEHA
Commercial · 2M+
Excellus BCBS
Regional · 1.5M+
Medica
Commercial · 1.5M+
IngenioRx
PBM · 40M+