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Commercial Small Group

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Information applicable to commercial small group members

Pharmacy Resources

2018 Resources

Drug Lists (Formularies)


Prior Authorization (PA) Requests and Formulary Exceptions

Medication Request and Exception Forms

Commercial Small Group prior authorization inquiries

PH: 1-800-294-5979 
FAX: 1-888-836-0730

 

2019 Resources

Drug Lists (Formularies)


Prior Authorization (PA) Requests and Formulary Exceptions

Medication Request and Exception Forms

Commercial Small Group prior authorization inquiries

PH: 1-800-294-5979 
FAX: 1-888-836-0730

Specialty Drug Program

Medica relies on preferred vendors to manage specialty drugs for members. As of 1/1/2018, Accredo Specialty Pharmacy is our preferred Specialty Drug Program vendor.

For access to specialty drug referral forms, visit Accredo Specialty Pharmacy’s referral form page, or call Accredo Specialty Pharmacy at 1-866-544-6817.

Group plan members who use a drug savings card to help pay for their specialty drugs filled through specialty pharmacy will experience a change in the way the savings applies to their plan starting 1/1/2018.

Drug Manufacturer Savings Card Program Changes (PDF)

Specialty Drug Lists

2018 Commercial Specialty Drug List (PDF)

 

Mail Order Pharmacy 

Medica offers prescription mail order through CVS Caremark Mail Service Pharmacy. With a 90-day prescription, members may receive a 90-day supply of their medication through the mail with no shipping or handling fees. Commercial and Individual and Family plan members can request prescription fills using the CVS Caremark website, using the CVS Caremark mobile app or by calling CVS Caremark Mail Service Pharmacy at 1-844-453-5186. These actions will initiate a quick start process allowing CVS Caremark Mail Service Pharmacy to work directly with the member’s prescriber. Prescribers may fax (1-800-378-0323) or e-prescribe (CVS Caremark Mail Service Pharmacy, NCPDP ID: 0322038, 9501 E Shea Blvd., Scottsdale, AZ 85260) prescriptions for their patients.

Diabetic Meters

OneTouch blood glucose meters and test strips are on Medica’s formulary as the preferred option. Members have access to one of the listed OneTouch blood glucose meters at no extra cost:

  • OneTouch Verio®
  • OneTouch Verio Flex
  • OneTouch Verio IQ

Compare OneTouch Verio meters

Members can receive a new preferred meter by calling CVS Caremark at 1-800-588-4456 or submitting a Diabetic Meter Request Form (PDF).


Starting January 1, 2019, Accu-Chek® blood glucose meters and supplies will be on Medica’s formulary as the preferred option. Members will have access to one of the listed Accu-Chek blood glucose meters at no extra cost:

  • Accu-Chek Guide
  • Accu-Chek Aviva Plus
  • Accu-Chek Nano

Members can receive a new preferred meter after January 1, 2019, by calling CVS Caremark at 1-800-588-4456 (toll free) between 8 a.m. and 6 p.m., Central Time, Monday through Friday, or submitting a Diabetic Meter Request Form (PDF).

Date: 12/14/2018 11:32:52 PM Version: 4.0.30319.42000 Machine Name: PWIVE-CMSWEB01