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Medicare and MediConnect Prior Authorization

Medicare Part Part D and Cal MediConnect Drug Prior Authorization Criteria

Below are the criteria (guidelines) for drugs that require prior authorization for Medicare Part B and Part D and Cal MediConnect members. Health Net Cal MediConnect Plan (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Please check your Evidence of Coverage or Member Handbook for details about your plan.

Last Updated: 10/01/2021