Plavix is no longer covered atorvastatin moved to tier 1. Navitus medicarerx pdp customer care can be reached toll free at 8662703877. Navitus medicarerx pdp 2020 formulary list of covered drugs. All requests for member reimbursement should be directed to the following address. The drug formulary serves as a guide for the provider. If you have questions, please call vhp member services at 1.
Welcome to navitus health solutions, the pharmacy benefit manager for arup laboratories. Specialty pharmacy navitus specialtyrx can help if you are taking medications for chronic illnesses or complex diseases. Christmas day, or visit the member portal at customer care also has free language interpreter services available for nonenglish speakers. Get your pharmacy benefits headed in the right direction for a savings of 1015%. Formulary the texas managed medicaid starchipstar kids formulary, including the preferred drug list and any clinical edits, is defined by the texas vendor drug program. Why should i use navitus specialtyrx for my specialty drug needs. C and o employees hospital association provides free aids and services to people. A drug formulary is a list of generic and brand name drugs identified as preferred or best in class based on overall value i. You will be reimbursed directly for covered services up to the navitus contracted amount. The navitus fraud, waste and abuse hotline number is 8556736503. The website lists both the email address and a toll free anonymous and confidential reporting hotline. Navitus does not send separate notices if a brandname drug becomes available as a generic drug.
The formulary is the list of medications covered by quartz through the prescription drug benefit. Quick reference formulary colorado access child health plan. Any specific questions regarding their coverage should be directed to l. Please refer to your vhp drug formulary, available, at. Each january 1st, all medicareeligible participants. Calls are routed directly to our special investigations unit. Formulary means a list of preferred prescription drug developed, published. To get updated information about the drugs covered by navitus medicarerx pdp, please contact us. Ask your preferred pharmacy to call navitus at 8663332757 to obtain information about joining our participating pharmacy network. If you have more questions about the formulary or your cost share, please contact navitus customer care. To start using navitus specialtyrx, please call toll free 18558473553. For employer group members, select the employer group formulary.
This tier may include generic, single source brand drugs, or multisource brand drugs. The pharmacist will fill the prescription for up to a 30 day supply of medication or possibly up to a 90 day supply, if applicable. Navitus formulary updates the following changes have taken effect recently or will take effect on july 1, 2012 for most clients utilizing the navitus formulary. Coverage of specialty drugs is subject to the members formulary. Formulary smoking cessation products are covered with a quantity limit of 90 days per calendar year. Mail or fax, or they can contact our call center to speak to a prior authorization specialist. C and o employees hospital association provides free aids and services to. The navitus specialtyrx pharmacy program is offered through a partnership. Local courier service is available for emergency, same day medication needs.
The navitus drug formulary navitus covers almost all medications. Navitus offers pharmacies access to a comprehensive list of resources via the pharmacy portal at. Please refer to your navitus formulary for a complete list of covered products. In the event of cmsapproved nonmaintenance changes to the formulary throughout the plan year, navitus medicarerx will notify you. Navitus participating pharmacies network listing final. However, the best way to access the correct formulary is through mychart or by entering your member number or group number on the formulary lookup. All members receive a new id card when they enroll. Changes to our pharmacy network may occur during the benefit year. This is where you can find information about your pharmacy benefit plan.
Please fill out all applicable sections on both pages completely and legibly. Please click on the links below to view the formulary documents. A member can make a request for reimbursement by completing the direct member claim form pdf. A formulary is a list of covered drugs selected by navitus medicarerx in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality. Prescription drug formulary and is not a guarantee of coverage. The contact information for navitus can be found on the back page titled resources, or 18663332757. Formulary the formulary tells you which prescriptions are covered and which tier a covered prescription falls under. Compounding pharmacies your provider must continue to use the vhp formulary when writing prescriptions, including those to be compounded. Below are the medications included on your preventive drug list.
Drug formulary legend and definitions alliant health plans. As the industrys alternative pharmacy benefit manager pbm, we. No, you are required to present a navitus id card to the pharmacy when you fill a prescription. Customer care toll free at 18663332757, with questions about the formulary. Please enter the information requested below exactly how it appears on your card. We will work with your prescriber for current or new specialty prescriptions. Members can reach navitus customer care 24 hours a day, 7 days a week, except thanksgiving and christmas day. The most updated version of this document, as well as a complete formulary listing, are available at. Your health plan is making an effort to reduce your health care costs by giving you tools to help you stay healthy and productive. You can call navitus customer care toll free at 8663332757 with questions about your formulary or look online at.
A formulary is a list of covered drugs selected by navitus medicarerx in. The formulary applies only to outpatient drugs provided to members, and does not apply to medications used in inpatient settings. If you have more questions about the formulary or your cost. Care health plan member services at 18888399909 tty. It is also here to give you useful information about drugs that may have been prescribed to you. The formulary is also available on t he formulary search mmit application for mobile devices. Experience the clarity, guidance and peace of mind of working with navitus. The information below will help you to identify which formulary is applicable to you. If an active ingredient in the compounded product is not on the vhp formulary, your provider is required to fill out a. A prescriber can submit a prior authorization form to navitus via u.
Navitus medicare rx where can i find my formulary information. Navitus offers pharmacies access to a comprehensive list of resources via the pharmacy portal at pharmacies can find answers to commonly asked questions such as how to process a pharmacy care incentives pci claim, recent navitus formulary updates or. Present your cur rent sisc id card to the pharmacist. Please contact navitus customer care toll free at the number listed on the members pharmacy benefit member id card for any inquiries related to the status of a pharmacy or to find a participating pharmacy near the member. Pharmacies can find answers to commonly asked questions such as how to process a pharmacy care incentives pci claim, recent navitus formulary updates or copies of payor sheets. This tier will contain lowcost or preferred medications. Search for sarasota memorial health care system formulary 15. We understand that as a health care provider, you play a key role in protecting the health of our members. Navitus considers current evidencebased guidelines, drug efficacy, fdaapproved indications, safety profile and prescribing patterns. Navitus specialty handout lumicera pdf pharmacy benefit manager services at navitus, teams of skilled physicians, researchers and analysts work together to find new and better ways to optimize the. Cvs caremark value formulary effective as of 04012020. We make managing your rx benefit seem like less work and more play. Pharmacy valley health plan members county of santa. Nov 01, 2017 drug formulary legend and definitions tier 1 firsttier drugs generally have the lowest costshare.
Tier 2 secondtier drugs will have a higher costshare than firsttier drugs. Pharmacynavitus health solutions toll free customer care18663332757. Quick reference formulary colorado access child health. Navitus pharmacy portal your pharmacy can use this portal to access your plans formulary. Customer care can be reached 24 hours a day7 days a week, except thanksgiving and christmas. The complete formulary can be found on our website. Reimbursement for drugs will be limited to those obtained while living or traveling outside of the united states and will be subject to the same restrictions and coverage limitations as set forth in this evidence of coverage document. These guidelines are based on clinical evidence, prescriber opinion and fdaapproved labeling information. If the pharmacy agrees to the terms of our pharmacy contract, it may join our pharmacy network and begin processing your prescriptions. Navitus believes that effective and efficient communication is the key to ensuring a strong working relationship with our participating pharmacies. Pharmacy benefits navitus health solutions uw service center. If the pharmacy you currently use is not listed, please contact navitus customer care toll free at the number listed on your pharmacy benefit member id card to confirm whether your current pharmacy is participating.
This resource is meant to help you keep uptodate with details about your benefit. More information about navitus specialtyrx is available at which of my medications are included in the navitus specialtyrx formulary. As a downstream entity of navitus health solutions, a firsttier entity to medicare part d plan sponsors, participating pharmacies are required to provide compliance and fwa training to all employees within 90 days of initial hiring and annually thereafter. Drugs will be filled as generics when acceptable generic equivalents are available. The request processes as quickly as possible once all required information is together. These medications help protect against or manage some high risk. Drug formulary legend and definitions tier 1 firsttier drugs generally have the lowest costshare. If the submitted form contains complete information, it will be compared to the criteria for. Navitus or badgercare members whose drug benefit is administered by forwardhealth. Decision guide page 74decision guide page 74 pharmacynavitus medicarerx pdp toll free customer care18662703877 medicarerx. Navitus uses the nppes database as a primary source to validate prescriber contact information. With navitus specialtyrx, delivery of your specialty medications is free, and right to your door or prescribers office via fedex. To try this program, your doctor needs to write a prescription for one of the program medications. A complete list of pharmacies is available in the navigate for members portal.
Calls to these numbers are free and you can call 24 hours a day, 7 days a week. For more information, please contact navitus medicarerx pdp customer care toll free at 18662703877 tty users please call 711, or visit our website at calls to these numbers are free. They provide services that offer convenience and support. Navitus clients experience lower than average pmpm. Lipitor is no longer covered kalydeco added to tier 2 and requires a prior. P rescription d rug p rior a uthoriz a tion r equest f orm planmedical group name. A formulary is a list of covered drugs selected by navitus medicarerx in consultation with a team of health care providers, which represents the prescription therapies. State and local government members should call navitus at 866. Please sign in by entering your npi number and state. The pharmacist usually tells you this information when you fill your next prescription. Employer drug formulary vhp uses a drug formulary list of covered drugs.
Navitus has contracted with pharmacies in texas to provide pharmacy access to texas managed medicaid starchip members. An updated pharmacy directory is located at you may also call customer care for. Navitus has contracted with pharmacies in texas to provide pharmacy access to texas managed medicaid starchipstar kids members. Quick reference formulary this document is subject to change. A formulary is a list of covered drugs selected by navitus medicarerx in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program.
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