Lighthouse Health Plan is committed to providing appropriate, high-quality, and cost-effective drug therapy to all Lighthouse members. Lighthouse covers a full range of prescription medicines and certain over-the-counter medicines with a written order from a Lighthouse Health Plan provider. Some prescription medicines have specific requirements and conditions that must be met before it can be received. This is called a prior authorization.
To learn more about which prescription medicines are covered and which require prior authorization, please review our Preferred Drug List or call the Lighthouse Pharmacy Services team at 1-844-716-5412.
Lighthouse Health Plan accepts the medication-specific pharmacy prior authorization forms published by the Agency for Health Care Administration at Pharmacy Prior Authorization Forms. Medications without a specific prior authorization form may be submitted on the Miscellaneous Medication Prior Authorization / Exception Form. Links to the miscellaneous and drug-specific authorization forms are posted below.
Pharmacy prior authorization requests for Lighthouse Health Plan enrollees must be submitted directly to Lighthouse via:
- Fax: 1-866-265-5511
- Mail:
Lighthouse Health Plan
Attn: Pharmacy Prior Authorization
700 E. Gregory Street
Ste. 150
Pensacola, FL 32502
Miscellaneous and Drug-Specific Authorization Forms
Abstral-Actiq-Fentora-Lazanda-Onsolis-Subsys Form
Adult High Dose Antipsychotic Form
Antidepressants Under 6 Years Form
Antipsychotic Under 6 Years Form
Antipsychotic 6 to 18 Years Form
HIV Diagnosis Verification Form
Neupogen Leukine Neulasta Granix Zarxio Form
Stimulant Less Than 6 Yrs Form