Prescription Drug Coverage

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CareSource RxInnovations™ has partnered with Express Scripts®, our Pharmacy Benefit Manager (PBM). A PBM helps health plans manage prescriptions.

Prescription Drug Benefits

CareSource Dual Advantage plans cover medications under Medicare Part D that help you stay healthy; see the Evidence of Coverage on the Plan Documents page for specific details. The plans uses a Comprehensive Formulary (a list of covered drugs approved by Medicare).

Here are some more important facts about the prescription program:

  • $0 copay for all covered medications.
  • Save a trip and get your medications delivered directly to you – mail order available at no extra cost for many of your prescriptions.
  • Up to 102-day supply prescriptions and dose packs for many drugs by mail or at retail pharmacies that you already use.
  • You may have copayments for your prescriptions.
  • You may also get Extra Help with the cost of your prescription drugs.
  • You have to go to a pharmacy that accepts CareSource Dual Advantage to get your prescriptions.
  • Your medication may have certain limitations. This may include requiring a prior authorization, step therapy, or quantity limit.
  • The prior authorization requirements for your medicines may change.

CareSource Dual Advantage™ (HMO D-SNP)

You have no copays for prescription drugs if you receive Extra Help.

If you have questions, call us at 1-833-230-2020 (TTY: 1-833-711-4711 or 711). We are open 8 a.m. to 8 p.m. Monday through Friday, and from October 1 through March 31 we are open the same hours, seven days a week.

*Certain medications called specialty medications are limited to no more than a 30 day supply per refill

*Cost-sharing amounts may change depending on the pharmacy you choose, days’ supply, what phase of the drug benefit you are in and your level of Extra Help. For more information on the additional pharmacy specific cost-sharing and the phases of the benefit, call the Member Services phone number on the back of your CareSource member ID card.

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