Pharmacy

CareSource covers prescription drugs that are filled at the pharmacy as part of your plan. CareSource works with our Pharmacy Innovation Partner – Express Scripts – to ensure that the most cost-effective drugs are covered for you.

• Price A Medication Tool – Check coverage limitations and price of medication.
• Prescription Drug Formulary – View the full Prescription Drug Formulary including any coverage limitations like prior authorization or step therapy restrictions.

CareSource helps you pay for covered prescription drugs and prescription medical supplies at the pharmacy. You may have a deductible and/or copayment or coinsurance for your prescriptions, depending on your plan. You can get your prescriptions at any pharmacy that accepts CareSource Marketplace. Use the Find a Pharmacy Quick Link on the left side (bottom) of the page to find a pharmacy near you.

Covered Prescriptions 

CareSource uses a Prescription Drug Formulary (or just Formulary). Your Formulary is a list of cost-effective drugs that you might use. Drugs and devices on the Formulary are covered for you, but sometimes limits apply. If you need a drug that is not included on the Formulary, you or your provider can request an exception to get it covered. Use the links above to search for your prescriptions to find out what drugs are covered and at what amounts for your plan.

Specialty Pharmacy

CareSource works with Accredo Specialty Pharmacy to supply specialty medications that your doctor may prescribe. Specialty drugs might be ordered when you have a chronic or difficult health condition. These drugs typically require special handling, monitoring, or special administration. If you have been prescribed specialty drugs, Accredo can:

• Help you get your prescription filled or moved from the pharmacy you get it from now.
• Deliver your specialty meds to your home, workplace or your doctor’s office.
• Help you learn about your specialty medication and give you support from specially-trained health care professionals.

For more information, call Accredo at 1-866-501-2009. They can take your call Monday through Friday from 7:30 a.m. to 9 p.m. Eastern Time (ET).

You may also visit the Accredo website to manage prescription refills for existing specialty mail order medications and check coverage information.

Mail Order Drugs

CareSource uses Express Scripts (ESI) to deliver medications your doctor may prescribe to your home. This may change your copay. This service can be used for maintenance drugs that you expect to be taking for an extended period. ESI will fill 90-day prescriptions by mail at a reduced cost. They can:

• Help you get your prescription filled or moved from the pharmacy you get it from now.
• Deliver your meds to your home, workplace or to your doctor’s office.

For more information, call ESI at 1-800-400-0126 from 8 a.m. to 8 p.m. Eastern Time, Monday through Friday.

You may visit access their website to manage prescription refills for existing mail order medications and check coverage information.