Medicare Advantage Plans

2016 CarePlus Prescription Drug Guides and Part D Information

CarePlus offers prescription drug coverage on all of its plans.

The Prescription Drug Guide, is the list of covered Part D prescription drugs selected by CarePlus. CarePlus worked with a team of healthcare providers to make a formulary that represents the prescription drugs we believe you need for a high-quality treatment program. The list must meet requirements set by the Centers for Medicare & Medicaid Services (CMS). Medicare has approved all of our drug guides. CarePlus will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a CarePlus network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, you must review your Evidence of Coverage (EOC).

Viewable Documents

Note: Our documents below are in Portable Document Format (PDF) and require Adobe Reader for viewing and printing. To get the plug-in, visit Adobe's Website to Download Adobe Reader.

South Florida:

Tampa Area:

Orlando Area:

Treasure & Space Coast:

North Florida:

The formulary may change at any time. You will receive notice when necessary.

Part D Utilization Management Requirements: Prior Authorization (PA), Step Therapy (ST), Quantity Limit (QL), and Exceptions

  • Miami Dade: All plans
  • Broward: All plans
  • Palm Beach: All plans, excluding CareFree (HMO)
  • Tampa area: All plans
  • Orlando area: All plans, excluding CareOne (HMO) which is only available in Lake, Marion, and Sumter
  • Palm Beach: CareFree (HMO)
  • Orlando area: Lake, Marion, Sumter - CareOne (HMO)
  • Treasure Coast area: CareOne (HMO)
  • Duval: CareOne (HMO), CareNeeds (HMO SNP), CareNeeds PLUS (HMO SNP)

Prescription Drug Transition Policy and Letter Template

CarePlus wants to make sure that you, as a new or existing member, safely transition into the new plan year when you are not able to get your drug because it is not on the current drug list or it requires prior authorization because of quantity limits, Step Therapy requirements, or confirmation of your clinical history. CarePlus’ Transition Policy helps you transition to a covered prescription therapy in the new plan year.

To learn more about the transition process, please review our Transition Policy.

PDF2016 TransitionPolicy-English (link opens in new window) 

PDF2016 TransitionPolicy-Spanish (link opens in new window) 

Please see below Template of CarePlus' Transition Letter

PDF2016 Transition Letter Template - English (link opens in new window) 

PDF2016 Transition Letter Template - Spanish (link opens in new window) 

How and Where to Send your Request for Prescription Drug Payment

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