Centene · Prior auth
Centene 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
60 days
Drugs covered
62
Centene 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 60 days to appeal. Criteria by drug below.
Prior authorization criteria by drug
Each page covers Centene's submission criteria, the documentation packet, and peer-to-peer prep for that drug.
- Adalimumab at Centene →
- Aflibercept at Centene →
- Apixaban at Centene →
- Atezolizumab at Centene →
- Atogepant at Centene →
- Benralizumab at Centene →
- Bevacizumab at Centene →
- Bictegravir at Centene →
- Buprenorphine at Centene →
- Dapagliflozin at Centene →
- Dulaglutide at Centene →
- Dupilumab at Centene →
- Eculizumab at Centene →
- Elexacaftor Tezacaftor Ivacaftor at Centene →
- Empagliflozin at Centene →
- Erenumab at Centene →
- Evolocumab at Centene →
- Faricimab at Centene →
- Fingolimod at Centene →
- Fremanezumab at Centene →
- Galcanezumab at Centene →
- Glecaprevir Pibrentasvir at Centene →
- Guselkumab at Centene →
- Ibrutinib at Centene →
- Imatinib at Centene →
- Inclisiran at Centene →
- Infliximab at Centene →
- Ixekizumab at Centene →
- Lenalidomide at Centene →
- Liraglutide at Centene →
- Lisdexamfetamine at Centene →
- Mepolizumab at Centene →
- Methylphenidate at Centene →
- Naltrexone at Centene →
- Natalizumab at Centene →
- Nintedanib at Centene →
- Nivolumab at Centene →
- Nusinersen at Centene →
- Ocrelizumab at Centene →
- Ofatumumab at Centene →
- Omalizumab at Centene →
- Ozanimod at Centene →
- Palbociclib at Centene →
- Pembrolizumab at Centene →
- Pirfenidone at Centene →
- Ribociclib at Centene →
- Rimegepant at Centene →
- Risankizumab at Centene →
- Rituximab at Centene →
- Rivaroxaban at Centene →
- Sacubitril Valsartan at Centene →
- Secukinumab at Centene →
- Semaglutide at Centene →
- Sofosbuvir at Centene →
- Tafamidis at Centene →
- Tenofovir Alafenamide at Centene →
- Tezepelumab at Centene →
- Tirzepatide at Centene →
- Tofacitinib at Centene →
- Trastuzumab at Centene →
- Upadacitinib at Centene →
- Ustekinumab at Centene →
Generate a Centene PA packet
Open ApprovalHelp — generate a prior-auth packet tailored to Centene's criteria, with prescriber attestation and step-therapy documentation pre-filled.
Get started →Contact: hello@approvalhelp.com