Pharmacy Policies

These administrative policies apply to our West Virginia plans on the Health Insurance Marketplace.

Administrative policies offer guidance on determination of medical necessity, investigation and experimental services.

Some administrative policies conjoin with our pharmacy policies (such as, non-formulary medications, off-label use, drug professional administration, etc.). Click below to review CareSource’s administrative policies for:

Review Admin Policies

The policies below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

NavigateView Current Pharmacy Policies

NavigateOncology Medications

Archived Pharmacy Policies