Welcome to the Maryland HealthChoice University of Maryland Health Partners formulary guide on Formulary Navigator™
Pharmacy webpage: https://www.umhealthpartners.com/find-a-drug-or-pharmacy/
Formulary Information: https://www.umhealthpartners.com/find-a-drug-or-pharmacy/drug-listformulary-updates/
Prior Authorization: https://www.umhealthpartners.com/find-a-drug-or-pharmacy/pharmacy-authorizations/
Please contact CVS Caremark for PA (Prior Authorization), QL (Quantity Limit), ST (Step Therapy), or Medication Exception review. You may:
- Call CVS/Caremark UMHP PA line at 1-877-418-4133. Hours are Monday-Friday 9:00 a.m. to 7:00 p.m., Saturday-Sunday 8:00 a.m. to 5:30 p.m., closed Holidays. Please be prepared to provide the clinical reviewer supporting documentation during this call. Or when you call CVS choose Option 1 to obtain a CVS Clinical Prior Authorization Criteria Request Form. This form can be used to begin the medication exception process. Or, you may use the following link to download a Clinical Prior Authorization Criteria Request Form: https://www.umhealthpartners.com/wp-content/uploads/2016/09/ClinicalPriorAuthCriteriaReqForm.pdf.
- Fax the completed Formulary Exception/Prior Authorization Request Form with clinical information to CVS Caremark at 1-855-762-5205. To download the Formulary Exception/Prior Authorization Request Form use the following link: https://www.umhealthpartners.com/wp-content/uploads/2016/09/Formulary-Exception_Prior_Authorization_Request-Form_617.pdf
- Submit an electronic PA request to CVS Caremark through CoverMyMeds at the following link: https://www.covermymeds.com/epa/caremark/
You may search the Formulary in several ways:
• Use the alphabetical list to search by the first letter of your medication.
• Search by typing part of the generic (chemical) and brand (trade) names.
• Search by selecting the therapeutic class of the medication you are looking for.
PLEASE NOTE: Because prescription drug programs vary by group, the inclusion of a drug in this formulary does not imply coverage. This formulary is subject to change throughout the year and plan exclusions may override this list. Benefit designs may vary with respect to drug coverage, quantity limits, step therapy, days supply and prior authorization. Please call the number listed on your member ID card if you have questions about your specific prescription drug benefits. Please discuss any questions or concerns about your drug therapy with your physician or pharmacist.