Elevate Medicare Advantage Pharmacy Prior Authorizations are reviewed by Medimpact.
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If you are a MEMBER and have questions about or want to submit a Prescription Drug Coverage Determination, call 303-602-2070.
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If you are a PROVIDER and have questions about or want to submit a Prescription Drug Coverage Determination, call 1-877-391-9291.
PDF Download
Click links below to download
- Request Medicare Prescription Drug Coverage Determination PDF Form - English
- Request Medicare Prescription Drug Coverage Determination PDF Form - Spanish