CoOportunity Health looks to clinical experts to determine what to include in our Drug List (Formulary). The physicians and pharmacists on our Pharmacy and Therapeutics Committee develop, manage, update and administer our drug list.
For certain drugs, the Pharmacy and Therapeutics Committee has developed criteria that must be met before the drugs will be approved for coverage. These drugs are noted on our drug list with a "PA" after their names.
Other drugs may have a medical policy. Many of these drugs also require a prior authorization. To narrow your search, enter the drug name or limit the Policy Category to Pharmacy.
We continually review and evaluate new and existing drugs to make sure our members get quality, safe and cost-effective medications. Updates to our drug list are posted quarterly.
NOTE: CoOportunity Health’s pharmacy benefit manager (PBM) is MedImpact.
The following resources provide additional information that will help you when providing care to our members.
|Search Our Drug List||Find out if a drug is covered or has coverage requirements|
|Drug List Updates||Access Fact Sheets announcing quarterly updates to our drug list|
|Find an In-Network Pharmacy||Help members keep out-of-pocket costs to a minimum by using in-network pharmacies|
|Specialty Pharmacy||Learn about the program and our exclusive specialty pharmacy provider|
|Policies and Forms||Access prior authorization forms and more|
|Medical Policies/Coverage Criteria||Locate coverage criteria for pharmacy and medical services|
|Medication Therapy Management Services||Read about a program that uses pharmacists to provide medication therapy services to our members|
To contact Pharmacy Customer Service, use the following information:
- Fax submission of prior authorization/exception requests is preferred: 1.888.883.5434.
- Telephone service is available at: 1.800.492.7259 from 8 a.m. – 6 p.m., CT, Monday through Friday. After-hours calls are answered by MedImpact, our Pharmacy Benefit Manager.
- Mail: HealthPartners Pharmacy Services, PO Box 1309, Minneapolis, MN 55440.