Senior Care Plus covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.
Formulary may change during the year. For the most up-to-date Formulary information, you can use the search box below or call Customer Service at 775-982-3112 or toll-free at 888-775-7003 Monday through Sunday, 7:00 a.m. to 8:00 p.m. TTY users should call the State Relay Services at 711. Customer Service also has free language interpreter services available for non-English speakers.
Senior Care Plus has two formularies. The most common formulary is the Medicare Advantage formulary. Listings of drugs covered on this plan and pharmacies you can access are provided below:
2018 Senior Care Plus Medicare Advantage Formulary information:
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
Here is the online search for the Medicare Advantage formulary. Please enter the drug name in the text box below and press search. The online search for the Prescription Drug Plan (PDP) formulary is farther down the page.
2018 Senior Care Plus Prescription Drug Plan (PDP) Formulary information:
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
Here is the online search for the Prescription Drug Plan (PDP) formulary. Please enter the drug name in the text box below and press search.
A coverage decision is a decision we make about your benefits and coverage or about the amount we will pay for your drugs. A coverage decision is often called an “initial determination” or “initial decision.” When the coverage decision is about your Part D drugs, the initial determination is called a “coverage determination.”
Here are examples of coverage decisions you ask us to make about your Part D drugs:
Prescription Drug Coverage Determination Request Form
If an existing member would like to request a prescription drug coverage determination regarding a prior authorization, quantity limit exception, step therapy exception, formulary exception, or a tiering exception, the member would complete the form and submit it to Senior Care Plus with a physician’s supporting statement.
You may also fax completed requests to Senior Care Plus at 775-982-3743.
If you disagree with a coverage decision we have made, you can appeal our decision.
You may also contact the pharmacy benefits manager at the contact information below:
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:
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 10/08/2018