Alabama Medicaid Tobacco Treatment Coverage
Medicaid Covered Services
Physicians can click to download this document containing information and instructions for Medicaid covered services.
Pharmacy Prior Authorization
Physicians can click to download this Pharmacy Prior Authorization Form.
Download: Pharmacy Prior Authorization
Fax Referral Form: English or Spanish
Download the form by clicking on the appropriate one, and fax it to 1-800-692-9023. The quitline will attempt contact with your patients for enrollment in quitline services. Progress reports are available upon request.
Download: English
Download: Spanish