Members

Prior Authorization form

Drug History/Patient Profile: For login and access information, contact 800-933-3734. Please be prepared to provide your current group number and member number.

Drug Formulary (Adobe Acrobat Reader is needed to see this file)

Drug Prior Authorization Form (Adobe Acrobat Reader is needed to see this file)

direct member reimbursement form

Direct Member Reimbursement Form (Adobe Acrobat Reader is needed to see this file)

http:// www.medsaveamerica.com (Click This Link for Mail-Order Prescriptions and Over-the Counter Medications and Supplies.)

MEDSAVE PRICING TOOL (http://medsave.rxinquiry.com/)
MedSave America LLC Formulary by Drug Name (Adobe Acrobat Reader is needed to see this file)
MedSave America LLC Formulary by Disease or Condition (Adobe Acrobat Reader is needed to see this file)
MedSave America LLC Plan Information (Adobe Acrobat Reader is needed to see this file)
MedSave America LLC FAQ (Frequently Asked Questions (Adobe Acrobat Reader is needed to see this file)

 

Healthstatrx.com (click this link for mail order and specialty drugs)
PharmaClear Formulary in Spanish (Adobe Acrobat Reader is needed to see this file)
Specialty Drug Article (Adobe Acrobat Reader is needed to see this file)
PharmaClear Introduction letter (Adobe Acrobat Reader is needed to see this file)
Generic (Genericos Medicamentos) Drug Brochure (Adobe Acrobat Reader is needed to see this file)
Ventajas de administrar los Beneficios de Farmacia con (Adobe Acrobat Reader is needed to see this file)
PharmaClear Marketing letter (Adobe Acrobat Reader is needed to see this file)
Contact Information: Member & Pharmacy Help Desks (Adobe Acrobat Reader is needed to see this file)