Aetna · Prior auth
Aetna prior authorization criteria
Submission criteria, documentation packets, and P2P prep by drug — for prescribers and PA staff. 30-day standard PA decision.
Standard PA decision
30 days
Appeal window if denied
180 days
Drugs covered
62
Aetna reviews prior-authorization requests against its published medical policies — diagnosis with ICD-10 code, documented step-therapy history, and prescriber attestation of medical necessity. Standard PA decisions return in 30 days; if denied, prescribers and members have 180 days to appeal. Criteria by drug below.
Prior authorization criteria by drug
Each page covers Aetna's submission criteria, the documentation packet, and peer-to-peer prep for that drug.
- Adalimumab at Aetna →
- Aflibercept at Aetna →
- Apixaban at Aetna →
- Atezolizumab at Aetna →
- Atogepant at Aetna →
- Benralizumab at Aetna →
- Bevacizumab at Aetna →
- Bictegravir at Aetna →
- Buprenorphine at Aetna →
- Dapagliflozin at Aetna →
- Dulaglutide at Aetna →
- Dupilumab at Aetna →
- Eculizumab at Aetna →
- Elexacaftor Tezacaftor Ivacaftor at Aetna →
- Empagliflozin at Aetna →
- Erenumab at Aetna →
- Evolocumab at Aetna →
- Faricimab at Aetna →
- Fingolimod at Aetna →
- Fremanezumab at Aetna →
- Galcanezumab at Aetna →
- Glecaprevir Pibrentasvir at Aetna →
- Guselkumab at Aetna →
- Ibrutinib at Aetna →
- Imatinib at Aetna →
- Inclisiran at Aetna →
- Infliximab at Aetna →
- Ixekizumab at Aetna →
- Lenalidomide at Aetna →
- Liraglutide at Aetna →
- Lisdexamfetamine at Aetna →
- Mepolizumab at Aetna →
- Methylphenidate at Aetna →
- Naltrexone at Aetna →
- Natalizumab at Aetna →
- Nintedanib at Aetna →
- Nivolumab at Aetna →
- Nusinersen at Aetna →
- Ocrelizumab at Aetna →
- Ofatumumab at Aetna →
- Omalizumab at Aetna →
- Ozanimod at Aetna →
- Palbociclib at Aetna →
- Pembrolizumab at Aetna →
- Pirfenidone at Aetna →
- Ribociclib at Aetna →
- Rimegepant at Aetna →
- Risankizumab at Aetna →
- Rituximab at Aetna →
- Rivaroxaban at Aetna →
- Sacubitril Valsartan at Aetna →
- Secukinumab at Aetna →
- Semaglutide at Aetna →
- Sofosbuvir at Aetna →
- Tafamidis at Aetna →
- Tenofovir Alafenamide at Aetna →
- Tezepelumab at Aetna →
- Tirzepatide at Aetna →
- Tofacitinib at Aetna →
- Trastuzumab at Aetna →
- Upadacitinib at Aetna →
- Ustekinumab at Aetna →
Generate a Aetna PA packet
Open ApprovalHelp — generate a prior-auth packet tailored to Aetna's criteria, with prescriber attestation and step-therapy documentation pre-filled.
Get started →Contact: hello@approvalhelp.com