What you need to know about the COVID-19 vaccine, your HAP coverage, and getting care during the pandemic.

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Medication Request Forms for Prior Authorization

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Participating physicians and providers requesting authorization for medications can complete the appropriate form below and FAX to (313) 664-8045.

For HAP Empowered Medicaid requests, please FAX the following form to (313) 664-5460.

For Medical Infusible Medication requests, FAX to (313) 664-5338.

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