• Provider Log-In for Eligibility and Claims
• Plans, Directories & Formularies
• Provider Directory by Service Area
• Prior Authorizations
• Provider Forms
• Pharmacy Coverage Determinations
• Appeals
• Provider FAQs
• Medication Therapy Management Program

Prior Authorizations

To view the current list of services and pharmaceuticals requiring prior authorization for members of our Windsor Medicare Extra Plans, please select from the list below:

Prior Auth Procedures (PDF)

Prior Auth Part B Drugs (PDF)

In addition, certain Part D covered drugs may require prior authorization, and/or have quantity limits or step therapy requirements. Please, go to Pharmacy Coverage Determinations for more information about these requirements and limits.

To view and download the Prior Authorization Request Form, please click on the link below:

Prior Authorization Request Form (PDF)