Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.
pharmacy prior auth
Part D coverage determination fax — Clinical Pharmacy Review (CarePlus)
Official page read
Phone
No phone listed for this route
Fax
877-486-2621
Part D coverage determination / exception request forms.
Published hours
Not published in this record
Product, plan and location
medicare advantage · medicare part d Florida
Mailing addressCarePlus Health Plans, Inc.
Attention: Clinical Pharmacy Review
P. O. Box 14601
Lexington, KY 40512-4165
Part D coverage determination requests by mail.
CarePlus Medicare Part D coverage determination request form (prescriber may submit). Fax and mailing address are printed on the form. Phone requests are directed to the CarePlus member services number on the same form.
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Separate pharmacy-benefit requests from drugs billed under the medical benefit. The PBM and the insurer may use different contacts.
Have ready in your secure workspace
PBM name and the pharmacy identifiers on the card
Drug, formulation and prescription information
Prescriber details and previous review reference
Questions to resolve
Is this processed under the medical or pharmacy benefit?
What is the correct review and submission channel?
Is there a separate specialty pharmacy or appeal team?
This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.
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A request does not create an account or start a call. Use business contact information only. No patient information.
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