Prior Authorization Forms

MDwise Medicaid Prior Authorization Process

In order to provide the most prompt response times to providers, all prior authorization requests must be faxed to MDwise.
For more information, see our Provider Prior Authorization Guide.


You can also view our comprehensive Prior Authorization quick contact guide that includes delivery system PA contact information for Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect.
 

UPDATE on MDwise Medicaid Prior Authorizations

Prior authorization requests for Indiana Health Coverage Programs: Hoosier Healthwise, Healthy Indiana Plan and Hoosier Care Connect
 

MDwise delivery system contact information for Hoosier Healthwise, HIP and Hoosier Care Connect prior authorizations.
 

Hoosier Healthwise

 

Healthy Indiana Plan


Hoosier Care Connect


MDwise Marketplace

 

For pharmacy prior authorization forms, please visit our pharmacy forms page.