Medicare AdvantagePrior AuthMedium impact
Medications Requiring Prior Authorization Under the Medical Benefit
Healthfirst·Prior Authorization
We identified it
Jun 20, 2026
Summary
Healthfirst has updated their list of medications requiring prior authorization under the Medical Benefit across multiple plan lines. This change affects medical claims for specific medications and applies to most Healthfirst products except Senior Health Partners.
Action Required
Immediately: Billing team must access the updated medication list at the provided URL and update prior authorization workflows for all Healthfirst medical benefit medication claims. Verify prior authorization requirements before submitting medical claims for medications. Monitor the policy page frequently for future updates as this list changes regularly.