Guam Medicaid Program

Formulary + Directory

• Download GUMED Medicaid Formulary
• Download Guam On-Island Directory

Prior Authorization Forms

Please complete the appropriate Prior Authorization form from the list below. Once completed, please submit the Prior Authorization form along with the required documentation via the Prior Authorization Process Initiation link.

• Download SGRX General PA Request Form
• Download Opioid PA Request Form
• Download Durable Medical Equipment (DME) and Supplies PA Form
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• Link to Prior Authorization and DME and Supplies PA Process Initiation
• Link to Pharmacy Network Inquiry
• Link to DME Claims Submission Form