Prescription Authorization

Prescription Drug Pre-Authorization Forms
Some prescription drugs require pre-authorization from Anthem Blue Cross Express Scripts Pharmacy management. You can view the list and download a pre-authorization form from the Anthem Express Scripts website.Contact: Express Scripts 1 (800) 700-7852 for additional information.

Drugs Requiring Pre-Authorization

Express Scripts Mail Order Enrollment/Refill Form

Express Scripts Retail Rx Claim Form

Anthem Blue Cross Formulary List (as of 7/1/2010)