Updated July 27, 2023
A MassHealth Prior Authorization Form is used by a medical office when they wish to request coverage from MassHealth for a prescription not listed on the formulary on behalf of a patient. This action is usually taken when other medications have been unsuccessful in treating their patient for a particular diagnosis. By filling and submitting this form, the medical professional may be able to secure coverage of a particular prescription for their patient.
- Fax: 1 (877) 208-7428
- Phone: 1 (800) 745-7318