UnitedHealthcare Community Plan
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Healthy Michigan Plan


Preferred Drug List (PDL) Search

Managed Care Common Formulary

Michigan PA Request Form for Prescription Drugs  (PDF 179.55 KB)


Pharmacy Prior Authorization Forms

Re-Review Reconsideration Request Form (PDF 158.04 KB)

 


UnitedHealthcare Community Plan


Preferred Drug List (PDL) Search

Managed Care Common Formulary

 

Pharmacy Prior Authorization Forms

Re-Review Reconsideration Request Form (PDF 158.04 KB)