Medicaid prior-authorization requests for the applicable CVS Caremark-administered benefit.
Published hours
Monday–Friday 8 a.m.–6 p.m. Central.
Product, plan and location
medicaid National contact — confirm product and location
Mailing address
Not researched for this route
Current CVS Caremark PA page publishes this Medicaid-specific phone/fax pair and general PA department hours. For a health care provider or authorized agent requesting PA for a Caremark-administered Medicaid benefit; confirm the patient’s plan and any state-specific form. This is not a help desk for every state Medicaid program.
commercial National contact — confirm product and location
Mailing address
Not researched for this route
Current Caremark Non-Medicare PA section publishes 800-294-5979 and ePA, but no generic fax. Its currently linked global form (106-37207A 081826) instructs electronic PA and does not publish 888-836-0730. That prior fax is withheld from this generic national route; this is not evidence of disconnection or cancellation of a plan/state-specific form that explicitly publishes it. Confirm patient benefit and applicable form; no dedicated specialty-PA scope inferred.
24 hours a day; maintenance/service downtime exceptions apply.
Product, plan and location
commercial · medicare part d National contact — confirm product and location
Mailing address
Not researched for this route
Dispensing-pharmacy claim-processing/IVR help desk. Select the correct benefit, system and member-card RxBIN/PCN; not a general member or prescriber clinical number. Commercial sheet lists Legacy ADV 004336, FEP 610239, Molina 025201, Blue Shield of California 026696, ScriptServ 026150, Lucile Packard Children’s Hospital Stanford 027547, Packard Children’s Health Alliance 027555, Children’s Health System of Texas 027570, Texas Children’s Hospital 028512 and OSCAR 028406. Medicare sheet also lists Molina 028272; supplemental sheet lists Legacy ADV 012114. For BIN 610591, Medicare sheet directs users to the plan or ID card rather than this number.
commercial National contact — confirm product and location
Mailing address
Not researched for this route
Dispensing-pharmacy claim-processing/IVR help desk. Select the correct benefit, system and member-card RxBIN/PCN; not a general member or prescriber clinical number. Commercial BIN 610415; the supplemental-to-Medicare-Part-D payer sheet lists Legacy PCS BIN 012114. Do not choose solely by the shared supplemental BIN.
Confirm the exact product or service National contact — confirm product and location
Mailing address
Not researched for this route
Dispensing-pharmacy claim-processing/IVR help desk. Select the correct benefit, system and member-card RxBIN/PCN; not a general member or prescriber clinical number. Only the Legacy CRK system/BIN 012114 row in the Supplemental to Medicare Part D Other Payer Patient Responsibility sheet. This supplemental-processing route is not a general Part D number.
Confirm the exact product or service National contact — confirm product and location
Mailing address
Not researched for this route
Dispensing-pharmacy claim-processing/IVR help desk. Select the correct benefit, system and member-card RxBIN/PCN; not a general member or prescriber clinical number. Only the Legacy PHC system/BIN 610468 row in the Supplemental to Medicare Part D Other Payer Patient Responsibility sheet. The commercial sheet separately says BIN 610468 is being retired and directs questions to 800-364-6331. Follow the actual benefit/system and ID card; do not treat these as equivalent nationwide routes.
commercial · medicare part d National contact — confirm product and location
Mailing address
Not researched for this route
Dispensing-pharmacy claim-processing/IVR help desk. Select the correct benefit, system and member-card RxBIN/PCN; not a general member or prescriber clinical number. Explicit Aetna BIN 610502 row in commercial, Medicare and supplemental payer sheets. This is the Caremark-processed dispensing-pharmacy route, not general Aetna medical claims or prescriber PA.
commercial National contact — confirm product and location
Mailing address
Not researched for this route
Dispensing-pharmacy claim-processing/IVR help desk. Select the correct benefit, system and member-card RxBIN/PCN; not a general member or prescriber clinical number. Commercial BINs 020099 and 020123. Medicare and supplemental payer sheets publish a different CarelonRx number. Supplemental processing even shares BIN 020099, so benefit/system information matters.
medicare part d National contact — confirm product and location
Mailing address
Not researched for this route
Dispensing-pharmacy claim-processing/IVR help desk. Select the correct benefit, system and member-card RxBIN/PCN; not a general member or prescriber clinical number. Medicare BINs 020115 and 020388; supplemental-to-Part-D sheet lists BINs 020099 and 020388. The commercial 020099/020123 route is 833-296-5038; do not choose from CarelonRx name alone.
24 hours a day per the pharmacy help-desk section.
Product, plan and location
Confirm the exact product or service Puerto Rico
Mailing address
Not researched for this route
Published Puerto Rico provider footnote attached to starred BIN entries: commercial Legacy ADV 004336/PCS 610415; Medicare Legacy ADV 004336; supplemental Legacy ADV/PCS/CRK 012114. Verify the patient card and applicable sheet. This does not establish a universal Puerto Rico member-service line.
commercial National contact — confirm product and location
Mailing address
Not researched for this route
Current official FEP page explicitly restricts this clinical call-center number to physicians requesting prior approval or quantity increases. Members seeking status should use their FEP prior-authorization page; general process questions have a separate Retail Pharmacy Program route. No fax inferred from the fax workflow description.
Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.
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Call preparation · editorial guide
Make the call count.
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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