CareSource RxInnovations™ has partnered with Express Scripts® to help you manage your prescriptions and save money.
- Drug Search: Check coverage and price of medication.
- Pharmacy Search: Find a pharmacy near you.
- Printed Formulary: Get more details about your medication coverage, including when you might need a pre-authorization and when you may need to try step-therapy.
Prescription Drug Benefits
CareSource Dual Advantage plans cover all medically necessary prescription drugs under Medicare Part B; see the Evidence of Coverage on the Plan Documents page for specific details. The plans use a formulary (a list of covered drugs) for drugs covered under Medicare Part D.
Here are some more important facts about the prescription program:
- You may have copayments for your prescriptions.
- You have to go to a pharmacy that accepts CareSource Dual Advantage plans to get your prescriptions.
- Your medication may have certain limitations.
- The prior authorization requirements for your medicines may change.
Have questions about your medication, ask a pharmacist!
Talk to a CareSource RxInnovations™ pharmacist to review your medication and get your questions answered. Depending on your medications and conditions, our pharmacists may even reach out to you to check in on your medications. As a CareSource member, you get this benefit for free. No appointment needed! Call 1-833-230-2073 to speak with a pharmacist today! We are open 9 a.m. to 5:30 p.m. Monday through Friday.
To learn more about covered drugs, review our Drug Formulary webpage.
Need Help Paying for Your Prescription Drugs?
If you are in a program that helps pay for your drugs (Extra Help), the information about costs for Part D prescription drugs may not apply to you. Please review How to Get Help with Drug Costs to learn about your drug costs if you get Extra Help. Many people are eligible and don’t even know. To see if you qualify, please follow the instructions in your Evidence of Coverage (Chapter 2, section 7). You can find this document and others on the Plan Documents page.
Low Income Subsidy (LIS) or “Extra Help” Cost Sharing Chart for Initial Coverage Phase
FPL < 100%
FPL > 100%
FPL 135 – 149%
*Certain medications called specialty medications are limited to no more than a 30-day supply per refill.
CareSource has contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your area. You may go to any of our network pharmacies. To find a network pharmacy near you, use our Find a Pharmacy search tool and select the link based on our county from the filter options.
Taking the correct dose of your medication at the right time is important in managing your medical issue(s). Your CareSource CM can guide you in obtaining adherence packaging from your retail pharmacist. This type of packaging organizes your drugs by dose, days of the week and time of day to aid you in taking your medications as prescribed.
CareSource offers mail-order service for prescription drugs. You can find additional information about this service on the Mail Order Drugs page and in your Evidence of Coverage on the Plan Documents page.
The formulary is a list of all drugs covered under your plan. CareSource provides monthly formulary updates to keep information current. For the most up-to-date information, you can always access our Find My Prescriptions online search tool
Drug Transition Policy
Under certain circumstances, during the first 90 days of your enrollment CareSource can offer a temporary supply of a drug to you when your drug is not on the drug list or when it is restricted in some way. Doing this gives you time to talk with your provider about the change in coverage and figure out what to do.
Learn more about the Drug Transition Policy.
Medication Therapy Management Program
CareSource offers a Medication Therapy Management (MTM) program to ensure your covered Part D drugs are appropriate, to improve your medication use and to reduce the risk of adverse events like drug interactions.
Learn more about the MTM program.
Drug Safety Recalls
Sometimes, the federal government issues drug recalls. To find out if a drug you take is being recalled, please check the listings on the U.S. Food & Drug Administration website.
Visit the Plan Documents page to view important documents about our plan’s prescription drug benefits.