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Information applicable to Medica Prime Solution Part D members

Pharmacy Resources


Preferred Drug Lists (Formularies)   

Part D Closed Formulary (Medica Prime Solution®) – (PDF)

Prior Authorization (PA) Requests and Formulary Exceptions

Medication Request and Exception Forms

Medicare Prior Authorization Inquiries
Phone: 1-855-344-0930
Fax: 1-855-633-7673

Part D Forms

Medwatch adverse drug reaction reporting forms

Prior Authorization and Step Therapy

Prime Part D Prior Authorization Formulary Criteria (PDF)
Prime Part D Step Therapy Formulary Criteria (PDF)

Part B Coverage

Blood Glucose Test Strips (Part B) – (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. Part D 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 1-844-470-5890. 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.

Date: 8/24/2019 10:42:02 PM Version: 4.0.30319.42000 Machine Name: PWIM4-CMSWEB01