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. Usually 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. They typically require special handling or 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 to 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 Standard Time (EST).

You may also access the Accredo website in order to manage prescription refills for existing specialty mail order medications as well as check coverage information.

Mail Order Drugs

CareSource uses Express Scripts (ESI) as its Pharmacy Innovation Partner to supply medications your doctor may prescribe to your home. This will change your copay. Express Scripts 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 1-800-959-3138 from 8 a.m. to 8 p.m. Eastern Time, Monday through Friday.

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