The management of outpatient prescription drugs is an integral part of the medical management program to improve the health and well-being of our members.

Prescriber and member involvement is critical to the success of the pharmacy program. To help your patient get the most out of their pharmacy benefit please be cognizant of the following guidelines when prescribing:

• Abbreviated Preferred Drug List
• Preferred Drug List
• Additions and Exceptions to the Preferred Drug List
• Generic Medications
• Injectable, Infusion Services
• Coverage Limitations
• Step Therapy Programs
• Over the Counter (OTC) Medications
• Pharmacy Lock- In Program
• Patient Co-payments
• Drug Evaluation Review Process
• Pharmacy
• Management- Network Improvement Program

To get a step-by-step overview see our  Pharmacy Services Guide. For detailed information see our  Pharmacy Service Handbook.

Pharmacy Forms

 Abbott Monitor Form 
 AccuChek Meter Form

 Coverage Determination Request Form

 Drug Evaluation Review for Orals-Solid Form
 Enteral Nutritional Supplement Form
 Injectable-Infusion Form
 Synagis Order Form 

 Xolair Request Form