Updated July 27, 2023
An Alaska Medicaid prior authorization form is filled out by a medical professional in order to request coverage through state Medicaid for a non-preferred drug prescription. Once completed, this form can be submitted to the fax number provided below. For more information, call the phone number found immediately below the fax number.
Fax – 1 (888) 603-7696
Phone – 1 (800) 331-4475
Preferred Drug List – Acceptable drugs by the State