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Pharmacy Preauthorization List Updates

07/13/2022

ConnectiCare and EmblemHealth are aligning how they communicate preauthorization requirements. EmblemHealth has separated the EmblemHealth Preauthorization List into two separate documents – one to house services covered by members’ medical benefits, and one to house services covered by members’ pharmacy benefits. (We discuss the changes to our medical preauthorization lists in a related story in our Clinical Corner section.) As part of this effort, the ConnectiCare Pharmacy Preauthorization List has also been reformatted. Both lists now include the July 1, 2022 CMS code updates.

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Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.