The Formulary is a list of covered drugs selected by Senior Care Plus 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. Senior Care Plus will generally cover the drugs listed in our Formulary as long as the drug is medically necessary, the prescription is filled at a Senior Care Plus network pharmacy, and other plan rules are followed.
Note: The effective date of this formulary is 01/01/2019. Scroll down to view the 2018 Formulary information.
Formulary – Medicare Advantage Plans with Rx Coverage – Effective: January 1, 2019
Formulary -Spanish – Medicare Advantage Plans with Rx Coverage – Effective: January 1, 2019
Step Therapy – Medicare Advantage Plans – Effective Date: January 1, 2019
Prior Authorization – Medicare Advantage Plans – Effective Date: January 1, 2019
Medicare Advantage & PDP Pharmacy Network – Senior Care Plus – January, 2019
Medicare Advantage & PDP Pharmacy Network – Senior Care Plus – January, 2019 – Spanish
Formulary – Medicare Advantage Plans with Rx Coverage – October, 2018
Formulary – Spanish – Medicare Advantage Plans with Rx Coverage – October, 2018
Step Therapy – Medicare Advantage Plans – October, 2018
Prior Authorization – Medicare Advantage Plans – October, 2018
Future Formulary Changes Medicare Advantage Plans with RX Coverage July, 2018
Medicare Advantage & PDP Pharmacy Network – Senior Care Plus – October 2018
Medicare Advantage & PDP Pharmacy Network – Senior Care Plus – October, 2018 – Spanish
Formulary – Standard Prescription Drug Plan – October 2018
Formulary – Spanish – Standard Prescription Drug Plan -October, 2018
Step Therapy- Standard Prescription Drug Plan (PDP) – October, 2018
Prior Authorization-Standard Prescription Drug Plan (PDP) October, 2018
Future Formulary Changes Standard Prescription Drug Plan (PDP) July, 2018
For the most up-to-date Formulary information, you can use our formulary search on our website or call Customer Service at 775-982-3112 or toll-free at 888-775-7003 (TTY users should call the State Relay Services at 711) Monday through Sunday, 7:00 a.m. to 8:00 p.m. Customer Service also has free language interpreter services available for non-English speakers.
Request a prescription drug coverage determination regarding a prior authorization, quantity limit exception, step therapy exception, formulary exception, or a tiering exception. This form may be sent to us in the following ways:
Mail Address: MedImpact Healthcare Systems, Inc. at 10680 Treena St., Stop 5, San Diego, CA 92131
Fax Number: 858-790-7100
You may also ask us for a coverage determination by:
Medicare Prescription Drug Determination Request (for use by member)
You can also access the Prescription Drug Coverage Determination Request form on the CMS website.
Medicare Part D Coverage Determination Request Form (for use by provider) – https://www.cms.gov/Medicare/Appeals-and-Grievances/MedPrescriptDrugApplGriev/index.html
You can get prescription drugs shipped to your home through our network mail order delivery program. You also have the choice to sign up for automated mail order delivery. If you sign up for our optional automatic delivery program, the mail-order “and retail” pharmacy will contact you directly before shipping “or delivering” to make sure that you still want any drug(s) scheduled for automatic delivery.
Typically, you should expect to receive your prescription drugs within 14 calendar days from the time that the mail order pharmacy receives the order. If you do not receive your prescription drug(s) within this time, please contact us at 800-681-9585, 24 hours a day, and seven days a week. TTY number/TRS Relay number 711.
Material ID: Y0039_2019_SCPWebsite_M (CMS Accepted) Last Updated 10/12/2018