Prescription medications
You can easily check the prescription medications we cover:
Statewide preferred drug list (PDL) (PDF)
If your medication isn’t listed, ask your provider:
To prescribe a similar one that’s on the Statewide PDL or Supplemental formulary
To get prior authorization (PA) for coverage
Need PA? Just ask your provider to fill out a pharmacy PA form. Or they can call 1-855-300-5528 (TTY: 711).
Did you pay for the cost of a prescription medication out of pocket? If yes, we can pay you back. Just fill out a prescription reimbursement form (PDF).
You can see the list of medications we cover for Home Infusion or Preferred Diabetic:
To see any Quantity Level Limits (QLL), you can check this QLL Document (PDF). For more info, you can visit the Kentucky Department of Medicaid Services Website.
You can get coverage for OTC medications on the Statewide PDL (PDF) or Supplemental formulary.
Meet any added requirements (for some medications)
Get a prescription from your doctor
Fill your OTC prescription at a pharmacy in our network
You can also call 1-855-300-5528 (TTY: 711). When you call, have a list of your OTC medications ready. You can ask if your medications are on the list.
If you need medication, your provider will write you a prescription for one on the Statewide PDL or Supplemental formulary. You’ll want to:
Ask your provider to make sure the medication is on the Statewide PDL or Supplemental formulary
Take your prescription to a pharmacy in our network
Show your plan member ID card at the pharmacy
Need refills? Your medication label notes how many refills you have. A few days before you run out of medication, call your pharmacy to place a refill order. If the pharmacy doesn’t have any refills left and you need more medication, check with your provider. They may want to see you before prescribing refills.
Fill your prescriptions
By mail
If you take maintenance medications for an ongoing health condition, you can get them by mail. We work with CVS Caremark® to give you this service at no extra cost. You can expect them to check each order for safety. And you can speak with a pharmacist anytime on the phone.
You’ll just need your:
Plan member ID card
Mailing address, including ZIP code
Doctor’s first and last name and phone number
List of allergies and other health conditions
Original prescription from your doctor (if you have it)
Just call CVS Caremark at 1-855-271-6603 (TTY: 711). You can call 24 hours a day, 7 days a week. They’ll let you know which medications they can fill with the CVS Caremark Mail Service Pharmacy. They’ll also contact your doctor for a prescription and mail your medication to you.
Already have a prescription?
You can sign up for mail service:
Online
Log in to the secure Member Portal. Then:
In “Tasks,” choose “pharmacy services”
Choose the “CVS” link to go to the CVS Caremark website
Choose “start mail service”
With an order form
You can fill out a mail service order form (PDF). Then, send it to:
CVS Caremark
PO Box 2110
Pittsburgh, PA 15230-2110
Or we can mail you a form. Just call us at 1-855-300-5528 (TTY: 711).
CVS Specialty® pharmacy provides many services, such as:
Delivery of specialty medications to your home or doctor's office
Counseling on your medications and conditions
Coordination of care with you and your doctor
The option to drop off your prescription and pick up your medication at any CVS Pharmacy® location
The ability to talk to a pharmacist 24 hours a day, 7 days a week
Have questions or need help with these services? Just call CVS Specialty pharmacy at 1-800-237-2767 (TTY/TDD: 1-800-863-5488).
BioPlus — fax: 1-800-269-5493
CVS Specialty — fax: 1-800-323-2445
Diplomat Specialty Infusion Group — fax: 1-513-792-3838
Elwyn Specialty Pharmacy — fax: 1-610-545-6030
Nufactor Inc. — fax: 1-855-270-7347
OptumRx of Indiana (BriovaRX) — fax: 1-877-342-4596
OptumRx of Tennessee (BriovaRX) — fax: 1-888-791-7666
Pharmascript — fax: 1-773-961-8907
ProCare Pharmacy Direct, LLC — fax: 1-412-825-8686
SenderraRx — fax: 1-888-777-5645
SimplicityRx — fax: 1-513-860-2436
St. Matthews Specialty Pharmacy — fax: 1-844-524-4673
University of Kentucky Specialty Pharmacy — fax: 1-859-323-1056
SimpleDose™
Need help organizing your medications? Pharmacists at your local CVS Pharmacy can do it for you at no extra cost. They'll put your maintenance medications in 30-day packs. And clearly label the time and date when you should take them. Then, they’ll send them to your home or local CVS Pharmacy.
You can sign up today:
Call CVS Pharmacy at 1-800-753-0596 (TTY: 711). They’re here for you Monday through Friday, 8 AM to 6 PM.
Sign up with a pharmacist at your local CVS Pharmacy.
Questions? Just call Member Services at 1-855-300-5528 (TTY: 711).
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