Utilization Management

The Utilization Management Department at Solis Health Plans is committed to ensuring that decisions regarding care for our members is based on appropriateness and does not use incentives to encourage barrier to care and service. For our Affirmative Statement, please click here.

To request a Service Authorization for a member, please download our form here and fax to 833-210-8141.

Part D Prior Authorization Criteria

This program requests prior approval before receiving a member’s medication to make sure they’re getting a prescription drug that is suitable for the intended use and covered by the prescription benefit. You can find that criteria here:

2024 Part D Prior Authorization Criteria

2023 Part D Prior Authorization Criteria