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. Some coverage changes my apply based on your benefit plan.

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

Adcetris

Adynovate 

Afstyla

Aldurazyme

Alimta

Alprolix

Aralast Np

Aranesp

Aripiprazole Lauroxil

Artesunate

Ayvakit 

Balversa 

Beleodaq 

Belrapzo

Benralizumab

Berinert

Besremi 

Bevacizumab

Beuprenorphine Implant

Bivigam

Blenrep

Blincyto 

Bortezomib 

Botox

Botulinum

Brineura

C1 Esterase Inhibitor 

Cablivi

Camptosar 

Carimune

Cerezyme

Cerliponase Alfa

Cinqair

Cinryze

Coagadex 

Copanlisib 

Cosela 

Crysvita

Cubicin 

Cuvitru

Danyelza 

Darzalex 

Durvalumab 

Dysport

Elaprase

Elelyso

Eligard 

Elitek 

Ellence 

Eloctate

Emicizumab-Kxwh

Empliciti 

Emtansine 

Enfortumab Vedotin

Enhertu 

Entyvio

Epoetin Alfa

Epoetin Beta

Epogen

Erbitux

Esperoct

Evenity

Evomela

Exkivity

Eylea

Fabrazyme

Factor Ix

Factor Viii

Fasenra

Faslodex

Firazyr

Flebogamma Dif

Flolan 

Folotyn 

Fotivda 

Fulphila

Gamastan

Gammagard

Gammaked

Gammaplex

Gamunex

Gavreto 

Glassia

Granix

Haegarda

Hemlibra

Herceptin

Herzuma 

Hizentra

Humate-P 

Hyqvia

Idamycin PFS 

Idelvion 

Ilaris

Imfinzi

Imlygic 

Inflectra 

Infugem

Inotuzumab Ozogamicin 

Inrebic 

Interferon Beta-1A

Interferon Beta-1B

Interferon, Alfa-2A

Interferon, Alfa-2B

Interferon, Alfacon-1

Interferon, Alfa-N3

Interferon, Gamma 1-B

Ipilimumab 

Istodax 

Ixempra Kit 

Ixifi

Jelmyto 

Jemperli 

Jevtana 

Jivi 

Kadcyla

Kalbitor

Kanjinti 

Kanuma

Keytruda

Khapzory 

Kogenate Fs

Kovaltry

Kyprolis

Lemtrada

Leukine 

Leuprolide Acetate 

Lorbrena

Lucentis

Lumakras 

Lumizyme

Lupron

Lutetium 

Makena

Margenza 

Mepsevii

Methotrexate 

Mircera 

Monjuvi 

Mozobil 

Mvasi

Mylotarg 

Myobloc

Myozyme

Naglazyme

Neupogen

Nivestym

Novoeight

Novoseven

Nplate

Nucala

Nuwiq 

Nyvepria 

Obizur

Ocrevus

Octagam

Ogivri 

Onivyde 

Onpattro

Ontruzant

Opdivo

Orencia Iv

Otrexup

Ozurdex 

Paclitaxel/Encequifar 

Padcev 

Parsabiv

Patisiran

Pemazyre 

Pepaxto 

Perjeta 

Phesgo 

Polivy 

Portrazza 

Prialt 

Privigen

Procrit

Prolastin-C

Prolia

Qinlock 

Rebinyn

Remicade

Remodulin

Renflexis

Retevmo 

Retisert 

Revcovi

Riabni 

Rituxan

Rozlytrek 

Ruconest

Ruxience

Rybrevant 

Rylaze 

Sandostatin

Sarclisa 

Signifor Lar

Simponi Aria

Soliris

Somatuline Depot

Stelara

Supartz

Supprelin LA 

Sylvant

Synagis 

Takhzyro

Tecentriq

Tepmetko 

Tivdak 

Torisel 

Totect 

Trastuzumab-hyaluronidase 

Trazimera 

Tretten 

Triluron

Trivisc

Trodelvy 

Trogarzo

Truseltiq 

Truxima

Tukysa 

Turalio 

Tivdak

Udenyca

Ukoniq 

Ultomiris

Ustekinumab

Vectibix 

Velcade 

Veletri

Vimizim

Vpriv

Wilate 

Xembify

Xeomin

Xgeva

Xiaflex

Xolair 

Xpovio 

Xyntha

Yervoy

Yutiq

Zaltrap 

Zaraxio

Zemaira

Zepzelca 

Zevalin Y-90 

Ziextenzo

Zinplava

Zirabev 

Zokinvy

Zoladex

Zynlonta 

* 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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For WEA Member Benefits (auto and home insurance & retirement services), call 800-279-4010

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