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2017 CarePlus Prescription Drug Coverage Information

CarePlus offers prescription drug coverage in all of its plans. This coverage may vary depending on the plan selected. To help you find the prescription drugs covered by your plan, please refer to the comprehensive formularies below.

The comprehensive formulary includes a list of covered drugs selected by CarePlus in consultation with a team of doctors and pharmacists, which represents the prescription drugs we think you need for a quality treatment program. 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, please review your Evidence of Coverage.

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:

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

Prescription Drug Transition Policy and Letter Template

We know that changing plans can be confusing. CarePlus wants to make sure that you, as a new or existing member, safely transition into the new plan year. If 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, we can help. CarePlus’ Transition Policy helps you transition to a covered prescription therapy in the first 90 days of enrollment in your plan.

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

PDF2017 TransitionPolicy-English (link opens in new window) 

PDF2017 TransitionPolicy-Spanish (link opens in new window) 

Please see below Template of CarePlus' Transition Letter

PDF2017 Transition Letter Template - English (link opens in new window) 

PDF2017 Transition Letter Template - Spanish (link opens in new window) 

How and Where to Send your Request for Prescription Drug Payment

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