UHA's Preferred Drug List provides a list of generic and preferred brand-name products covered by UHA prescription drug plans.

Certain drugs require prior authorization and these forms are listed below.

Please follow the instructions on the Prior Authorization form and submit the request to UHA's Pharmacy Benefit Manager, Restat, by fax or mail as directed on the form.

Prior Authorization Forms

For prior authorization of prescription drugs not listed below, please use Prior Authorization Questionnaire

The forms and documents on this page require the free Adobe Acrobat Reader, version 7.0 or above. Please download it here