To find out if prior authorization from Highmark Health Options is required for medical procedures and services, use the Prior Authorization Code Lookup.
keyboard_arrow_up BACK TO TOP
*Highmark Health Options does not publish a MAC Pricing List as pharmacy reimbursement occurs in accordance with Delaware House Bill 219 which indicates the National Average Drug Acquisition Cost (NADAC) as the required reimbursement methodology.
Highmark Health Options requires prior authorization from HealthHelp for oncology medications. Submit prior authorizations in the Provider Portal via NaviNet.
Follow the instructions under the Prior Authorization with HealthHelp tab on the Provider Resources page.
CoverMyMeds helps patients get the medication they need to live healthy lives by streamlining the prior authorization process for providers and pharmacists. Start today by creating a free account, or logging in to your existing account at CoverMyMeds.com.
Highmark Health Options works with Free Market Health to enhance our specialty pharmacy program. Through their platform, we connect members with the most suitable in-network specialty pharmacy, ensuring member choice and continuity of care. Please note: From time to time, prescribers may receive a request to transfer a prescription to a new specialty pharmacy as a result of this process.
StellarRx provides on-site stocking and inventory management of asthma (i.e., inhalers, nebulizers, and supplies) and contraceptive (i.e., birth control pills, IUDs and subdermal implants) medications in a secure XpeDose™ cabinet, ready for use in a single visit. This prescription dispensing system is available to all Highmark Health Options providers free of charge. Learn more about StellarRX by visiting their website or reviewing the following resources:
Health professionals, patients, and consumers can voluntarily report adverse events of human medical products. Adverse events may be suspected or observed, and they include problems or use/medication errors. Voluntary reporting helps bring to attention to unknown risks for FDA-approved medical products. Reporting can be done by phone, by fax, through the FDA MedWatch online reporting portal, or by downloading, completing, and submitting the FDA Form 3500 (Voluntary Reporting).
Type keyword in the search bar or scroll through the prior authorization forms listed below.
Additional prior authorization requirements may apply. Refer to the Delaware Medicaid Preferred Drug List (PDL) for any additional prior authorization requirements.
If you can't find the information you need here, call Pharmacy Services at 1-844-325-6251.
