Members
Employer coverage
Pharmacy information
Pharmacy forms
- Prescription Claim Form [pdf]
- Prescription Mail Service Order Form [pdf]
If your policy has a mail-order drug benefit, use this form to order new and/or refill mail service prescriptions. - Prior Approval Form for Prescription Drugs [pdf]
This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information, sign and date. Fax signed forms to CVS/Caremark at 1-855-245-2134 for prior approval and quantity limit requests. Contact CVS/Caremark at 1-855-582-2022 with questions regarding the prior approval and quantity limit review process. For Step Therapy and Non-Formulary Exception requests, fax the form to 501-378-6980. For Step Therapy and Non-Formulary Exception request questions, contact 501-378-3392. - Language Assistance Available [pdf]
Employer coverage drug lists
Understanding your pharmacy coverage
- Using your pharmacy benefits
How to use your benefits and the advantages your pharmacy plan offers you. - Pharmacy claim search in My Blueprint
Your prescription claims history, including prescription number, date filled, prescriber, quantity, pharmacy, amount paid by you and amount paid by your pharmacy plan. To access information about your personal pharmacy claims, you must register to use My Blueprint, our member self-service center. - Network pharmacy search
- Drug pricing
- Save money on medications
- How to read labels
- Generic medications
- Specialty drugs
- What is step therapy? [pdf]
- Free immunizations at pharmacy
Mail-order drugs
For those members with mail-order drug benefit, an online service is available, which allows you to:
- Refill your mail-order prescriptions;
- Check the status of your mail order;
- Review your mail-order prescription history.
For more information, visit Pharmacy site on My Blueprint. Or download and complete the paper form. [pdf]