Provider Pharmacy Resources

Pharmacy Resources

CarePlus Drug List

Access prescription drug guides and Part D utilization management requirements by visiting the CarePlus Prescription Drug Information page.

Part D Coverage Determinations

Find out how to request a coverage determination for a Part D prescription drug and access coverage determination request forms.

PDFHow to Request a Coverage Determination or an Exception (PDF opens in new window) 

PDFPrescription Drug Coverage Determination Request Form (PDF opens in new window) 

If you prefer, you may complete the Coverage Determination Request (link opens in new window) . Before completing the online request, you may want to view our accepted file types (link opens in new window) .

You also can access the Medicare Coverage Determination Request Form at the following CMS Part D webpage link: Part D Coverage Determination Request Form (link opens in new window) .

Medication Therapy Management (MTM) Program

To learn how we help eligible members better understand their medications, please visit our MTM Program page.

Transition Policy

CarePlus makes arrangements to continue to provide necessary drugs to our members through a transition period. Read about our Part D transition policy.

PDFPart D Prescription Drug Plan Transition Policy for Providers (PDF opens in new window) 

Pharmacy Manual

CarePlus appreciates your participation and role in delivering quality pharmacy services to your CarePlus-covered patients. The CarePlus Pharmacy Manual is intended to assist pharmacy staff in processing claims for CarePlus plans.

PDFCarePlus Pharmacy Manual (PDF opens in new window)