Pharmacy Information And Tools

Healthy Blue will administer pharmacy benefits for enrolled members. CarelonRx* is the pharmacy benefit manager.

Medicaid

Please refer to the Healthy Blue Preferred Drug List (PDL) when prescribing for our members. This guide does not contain a complete list of drugs; rather, it lists the preferred drugs within the most commonly prescribed therapeutic categories.

Though most medications on the PDL are covered without prior authorization, a few agents will require you to contact our Pharmacy department for authorization.

Electronic prior authorizations (ePA)

Electronic prior authorization requests can be submitted through CoverMyMeds, an independent company providing medication prior authorization services on behalf of Healthy Blue.

CoverMyMeds streamlines the medication prior authorization process, electronically connecting providers, pharmacists, and plan/PBMs to improve time to therapy and decrease prescription abandonment with electronic prior authorization.

Using CoverMyMeds for prior authorization (PA) requests

Prescribers can view real-time status of any medication PA request submitted via ePA, phone, or fax by logging into the CoverMyMeds website and entering the member’s information. Prescribers also have the option to contact CoverMyMeds directly by calling 866-452-5017 from 7 a.m. to 10 p.m. CST Monday to Friday, 8 a.m. to 4 p.m. CST on Saturday for questions, information, or website concerns, or via live chat on the CoverMyMeds website.

Prior Authorizations By Phone:

You can reach our Pharmacy department at 833-388-1406 between 7 a.m. and 8 p.m. CST Monday to Friday.

833-388-1406

Prior Authorizations By Fax:

You can also fax your request to our Pharmacy department:

Retail prior authorization:

833-370-0702

Medical injectables:

833-370-0678

Hot Tips

Pharmacy Hot Tips are brief messages to help answer questions and/or concerns you may have around a variety of pharmacy topics. Topics include preferred formulary products used to treat common diseases and conditions such as asthma and diabetes.

If you would like additional pharmacy information to assist our members, contact your Provider Relations representative, and we will prepare a pharmacy Hot Tip for you!