Information Regarding Prescription Drug Preauthorization

Prescription Drug Preauthorization

Helping keep costs down and getting the most appropriate treatment.

The WEA Trust requires preauthorization for certain prescription drugs.The sections below detail which drugs are handled by which company.

Questions About Drug Preauthorization?

WEA Trust Customer Service for Members: 800-279-4000
WEA Trust Customer Service for Providers: 800-279-4090
MedImpact: 888-807-8106

 

Q:Managed By MedImpact

For a list of the most Common Drugs Requiring Preauthorization, please reference our Preferred Drug List.

For a complete list, please reference our Complete Formulary.


Most common prescription drugs requiring preauthorization:

  • Adapalene (over age 25)
  • Androgel
  • Aripiprazole
  • Copaxone
  • Crestor
  • Dextroamphetamine-amphetamine (quantity limit)
  • Dextroamphetamine-amphetamine ER (over age 18)
  • Elidel
  • Enbrel
  • Enoxaparin Sodium
  • Fentanyl
  • Gleevac
  • Harvoni
  • Humira
  • Imiquimod
  • Jublia
  • Latuda
  • Methylphenidate ER (over age 18)
  • Modafinil
  • Neulasta
  • Nexium
  • Nuvaring
  • Nuvigil
  • Pristiq ER
  • Sovaldi
  • Subuxone
  • Tecfidera
  • Tretinoin (over age 25)
  • Vancomycin
  • Vesicare
  • Vyvanse
  • Xyrem
  • Zolpidem tartrate ER

Q:Managed By WEA Trust

Preferred Biosimilars

Click here for the preferred Biosimilars chart

Prescription Drugs Requiring Preauthorization

Please use our Medication Preauthorization Form for the following medications:

Abraxane

Actemra

Acthar Hp

Adagen

Afstyla

Aldurazyme

Alimta

Alprolix

Aralast Np

Aranesp

Aripiprazole Lauroxil

Benralizumab

Berinert

Beuprenorphine Implant

Bivigam

Botox

Botulinum

Brineura

Cablivi

Carimune

Cerezyme

Cerliponase Alfa

Cinqair

Cinryze

Cosela 

Crizanlizumab

Crysvita

Cuvitru

Danyelza 

Durolane

Dysport

Elaprase

Elelyso

Eloctate

Emicizumab-Kxwh

Enfortumab Vedotin

Entyvio

Epoetin Alfa

Epoetin Beta

Epogen

Erbitux

Esperoct

Euflexxa

Evenity

Evomela

Eylea

Fabrazyme

Factor Ix

Factor Viii

Fasenra

Faslodex

Firazyr

Flebogamma Dif

Flolan 

Fulphila

Gamastan

Gammagard

Gammaked

Gammaplex

Gamunex

Gel-One

Gelsyn-3

Genvisc 850

Glassia

Granix

Haegarda

Hemlibra

Herceptin

Hizentra

Hyalgan

Hydroxychloroquine

Hymovis

Hyqvia

Ilaris

Imfinzi

Infugem

Interferon Beta-1A

Interferon Beta-1B

Interferon, Alfa-2A

Interferon, Alfa-2B

Interferon, Alfacon-1

Interferon, Alfa-N3

Interferon, Gamma 1-B

Istodax 

Ixifi

Kadcyla

Kalbitor

Kanuma

Keytruda

Kogenate Fs

Kovaltry

Lemtrada

Lorbrena

Lucentis

Lumakras 

Lumizyme

Lupron

Makena

Margenza 

Mepsevii

Monovisc

Mvasi

Myobloc

Myozyme

Naglazyme

Neulasta

Neulasta Onpro

Neupogen

Nivestym

Novoeight

Novoseven

Nplate

Nucala

Obizur

Ocrevus

Octagam

Onpattro

Ontruzant

Opdivo

Orencia Iv

Orthovisc

Otrexup

Paricalcitol

Parsabiv

Patisiran

Pepaxto 

Privigen

Procrit

Prolastin-C

Prolia

Rebinyn

Remicade

Remodulin

Renflexis

Retacrit

Revcovi

Rituxan

Ruconest

Ruxience

Rybrevant 

Sandostatin

Signifor Lar

Simponi Aria

Soliris

Somatuline Depot

Stelara

Supartz

Synagis 

Synojoynt

Synvisc

Synvisc-One

Takhzyro

Tecentriq

Triluron

Trivisc

Trogarzo

Truseltiq 

Truxima

Udenyca

Ultomiris

Ustekinumab

Vectra Da

Veletri

Vimizim

Visco-3

Vpriv

Xembify

Xeomin

Xgeva

Xiaflex

Xolair

Xyntha

Yervoy

Zaraxio

Zemaira

Ziextenzo

Zinplava

Zokinvy

Zoladex

* Please see additional prescription drug policies (below) for new drugs, oncology drugs, and opiate medications.

Additional Prescription Drug Policies


Customer Service

800-279-4000

Call us Monday through Friday - 7:30 a.m. to 5:00 p.m. CST

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