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Pharmacy
https://www.caresource.com/plans/mihealthlink/benefits-services/pharmacy/...drugs we want your primary care provider (PCP) to order for you. Some drugs require prior authorization. Some drugs may also have quantity limits, and some drugs may require step...
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Part D Prescription Plan Rights
https://www.caresource.com/members/tools-resources/grievance-appeal/part-d-prescription-plan-rights/...D drug that is not on the plan’s formulary. Asking us to waive restriction on the plan’s coverage for a drug such as limits on the amount of the drug...
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Pharmacy Benefit Manager
https://www.caresource.com/providers/education/patient-care/pharmacy/prescription-drug-coverage/pharmacy-benefit-manager/...third-party company that manages prescription drug benefits on behalf of CareSource by negotiating with drug manufacturers and pharmacies to control drug spending. For more information visit: https://www.express-scripts.com/pharmacy-benefits-manager CareSource RxInnovations™ has...
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FAQs
https://www.caresource.com/members/education/faqs/...our most asked questions! What is a formulary? A formulary is also known as a drug list. View your formulary on our Plan Documents page. What is a prior authorization?...
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Pharmacy Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/pharmacy-policies/...Zinplava (bezlotoxumab) Zoladex (goserelin acetate) Zolgensma (onasemnogene abeparvovec-xioi) Zynteglo (betibeglogene autotemcel) These pharmacy policies are applicable to provider-administered drugs covered by TrueCare Mississippi Medicaid. The below drugs may be reimbursable...
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Archived Reimbursement Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/reimbursement-policies/archived/...Drug Testing Drug Testing Drug Testing Drug Testing Drug Testing E Emergency Department Electrocardiogram (EKG/ECG) Interpretation Epidural Steroid Injections Epidural Steroid Injections F Facet Joint Interventions Facet Joint Interventions Facet...
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Platinum Plans
https://www.caresource.com/plans/marketplace/plan-documents/platinum-plans/...Drugs + Adult Vision & Fitness 2025 Platinum Zero $5 Generic Drugs Platinum Zero $5 Generic Drugs Adult Vision & Fitness Platinum Zero $5 Generic Drugs Platinum Zero $5 Generic...
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Healthy Heart
https://www.caresource.com/plans/marketplace/healthy-heart/...for check-ups and screenings. Expanded Drug Formulary: Easier access to the drugs that you need to treat your heart condition. Medication Management: Support from pharmacists to manage heart and other...
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Pharmacy
https://www.caresource.com/plans/mycare-snp/benefits-services/pharmacy/...Drugs Our policy is to limit the use of a brand-name drug when a generic version is available. Generally, a generic drug works the same as a brand-name drug and...
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Archived Medical Policies
https://www.caresource.com/providers/tools-resources/health-partner-policies/medical-policies/archived/...(CGM) Continuous Glucose Monitoring Systems (CGMS) Continuous Glucose Monitoring Systems (CGMS) Continuous Glucose Monitors D Drug Testing Drug Testing Drug Testing Drug Testing Drug Testing Drug Testing Drug Testing Drug...
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