Pharmacy Prior Authorization form
Please review the attached list to see if the medication requires a prior authorization and if it will be processed through the pharmacy or medical benefit. Together with CCHP's Medication List
To view or print off a specific prior authorization form, click on the medication name below:
Medications A - M
Medications N - Z
Children's Community Health Plan
PO Box 56099 Madison, WI 53705 1-800-482-8010
PO Box 1997, MS 6280 Milwaukee, WI 53201 1-844-201-4672