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Pharmacy FAQ

Q:  Who should I contact for copies of the HealthPlus drug formulary, formulary quick check documents and other Pharmacy information?

A:  Please contact the HealthPlus Pharmacy Department at (810) 230-2118 or at rx@healthplus.org.

 

Q:  How can I get updated copies of the Pharmacy Prior Authorization Criteria and Prior Authorization request form?

A:  View the online HealthPlus Pharmacy Prior Authorization Form  or  contact the HealthPlus Pharmacy Department at (810) 230-2118 or by email at rx@healthplus.org .

 

Q:  How do I appeal a determination made related to a medication I prescribed?

A:  Contact the HealthPlus Customer Service Department at (800) 332-9161, to initiate the appeal process.

 

Q:  Do I need a prior authorization number?

A:  No. If a medication is authorized, HealthPlus will place a patient- and drug-specific override into the claims processing system so that the claim will pay.

 

Q:  How long does a prior authorization remain in place?

A:  For most medications, the authorization is permanent.

 

Q:  If I have not obtained prior authorization yet, will my patient receive their medication at the pharmacy if it is after normal business hours?

A:  Yes. For any medication that requires prior authorization, the pharmacy may provide a one-time starter dose for up to a seven day supply. The HealthPlus Pharmacy Department will follow up with the physician’s office to initiate the prior authorization process.

The starter dose may not apply to benefits with a closed drug formulary.

 

Q:  How can I get a personalized pharmacy review?   

A:  Please contact the HealthPlus Pharmacy Department at (810) 230-2118 to request a personalized review and evaluation of opportunities to improve your prescribing method. This review may include a one-on-one discussion with a HealthPlus pharmacist.

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