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Medicare/MHCP Plans

Pharmacy Overview for Providers Home > Combined Medicare and MHCP Programs

Information applicable to Medica DUAL Solution® members and Medica AccessAbility Solution® Enhanced members (Rx Group #8623, #3462, #8719, #3219)

Pharmacy Resources


We’re making important changes to our pharmacy program for 2020. We've created a special website to help assist you and your patients through our Jan. 1 pharmacy benefit manager transition.

View pharmacy program changes >

Covered Drug Lists (Formularies)

Prior Authorization and Formulary Exceptions

NOTE: Prior authorization and formulary exception requests may be submitted to Express Scripts® for review starting January 1, 2020.

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 via:

  • CVS Caremark website
  • CVS Caremark mobile app
  • 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.

PLEASE NOTE: Starting January 1, 2020, Medica will transition to Express Scripts PharmacySM for prescription mail services. Members will be able to continue receiving a 90-day supply of their long-term drugs through the mail with no shipping or handling fees.

Date: 11/18/2019 7:34:28 PM Version: 4.0.30319.42000 Machine Name: PWIVE-CMSWEB02