Members
Pharmacy information
Before proceeding, check with your group administrator or call Customer Service to see if your plan includes pharmacy benefits.
- View your claims in Blueprint Portal
Your prescription claims history, including prescription number, date filled, prescriber, quantity, pharmacy, amount paid by you and amount paid by your pharmacy plan. To access information about your personal pharmacy claims, you must register to use Blueprint Portal, our member self-service center. - Network pharmacy search
- Specialty drugs
A description of the program that covers injectable and select oral medications. - What is step therapy? [pdf]
- Clinical Documentation
Mail-order drugs
For those members with the mail-order drug benefit, an online service is available, which allows you to:
- Refill your mail-order prescriptions;
- Check the status of your mail order;
- Review your mail-order prescription history.
For more information, log in to Blueprint Portal and navigate to the pharmacy page. Or download and complete the paper form. [pdf]
Pharmacy forms
- Prescription Claim Form
[pdf]
- Prior Approval Form for Prescription Drugs [pdf]Information contained in this form is Protected Health Information under HIPAA Complete/review information, sign and date. Fax signed forms to CVS/Caremark at 855-245-2134 for prior authorization, step therapy, and quantity limit requests. Contact CVS/Caremark at 855-582-2022 with questions regarding the step therapy, prior authorization and quantity limit review process. For Non-Formulary Exception requests, fax the form to 501-378-6980. For Non-Formulary Exception request questions, contact 501-378-3392.