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1230 US Highway 11 Governor, NY 13642 Phone: 18776359545 Prior Authorization Fax: 18447128129 Upgrade Prior Authorization Request Form (Page 1 of 2) Member Information (required)Provider Information

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How to fill out automatic refills

01

Go to the automatic refills section on the website or mobile app

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Select the medication that you want to enroll in automatic refills

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Confirm the enrollment and you're all set for automatic refills

Who needs automatic refills?

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Anyone who regularly takes medication and wants to ensure a continuous supply without manually placing refill orders.

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Individuals with chronic conditions who require ongoing medication.

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Patients who often forget to refill their prescriptions in a timely manner.

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