Members

Pharmacy information

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]

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

For those members with mail-order drug benefit, an online service is available, which allows you to:

For more information, visit Pharmacy site on My Blueprint. Or download and complete the paper form. [pdf]