Provider Pharmacy Resources

Pharmacy Resources for Healthcare Providers

CarePlus’ Drug List

Access formulary lists and Part D utilization management requirements by visiting the CarePlus Prescription Drug Guides and Part D 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 (link opens in new window) 

PDFMedicare Coverage Determination Request Form (link opens in new window) 

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

You can also 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) .

Additional Fax Forms

Medication Therapy Management (MTM) Program

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

Transition Policy for Providers

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 (link opens in new window) 

Pharmacy Manual

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

PDFCarePlus Pharmacy Manual (link opens in new window) 

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