PHARMACY COVERAGE FOR CCH MEMBERS
CCH has partnered with MedImpact as our Pharmacy Benefit Manager to provide prescription drugs to our members. To find a participating pharmacy, please go to “Find a Provider” and click on the Pharmacy Tab.
CCH members are able to obtain a 90-day supply of ongoing medications through the mail-order program with MedImpact Direct. With mail-order, members can have their prescriptions delivered right to their home. To submit a prescription on behalf of a CCH member please click on the link to complete a MedImpact Direct Medication Order Form and submit electronically via ePrescribing or fax to 888-783-1773.
See what's covered for CCH members
Commonly Prescribed Medications
MedImpact has created a list of commonly prescribed medications within select classes of drugs covered by the member’s prescription drug plan. The PDL was created to promote clinically appropriate utilization of medications in a cost-effective manner.
For Community Medical Centers members, click here to download the Preferred Drug List (PDL).
For all other members, click here to download the Preferred Drug List (PDL).
Formulary Exception Request Process
MedImpact has established a process for providers to obtain non-preferred drugs (Formulary Exception) for members.
A physician may request a Formulary Exception if the following rules have been met:
- The request for coverage is for an indication supported by the medical literature.
- To be considered, a request for a Formulary Exception can be submitted after the member has undergone a therapeutic trial with at least two different formulary medication alternatives to the non-formulary medication being requested. In cases where only one formulary alternative exists, an adequate therapeutic trial with this one formulary alternative will be required before coverage of the non-formulary medication will be considered.
- Use of covered alternatives must be for a reasonable period of time, generally defined as one month of therapy or more, except in cases where the physician indicates clinical reason why alternatives are ineffective, intolerable, or unsafe.
- If the physician’s request for coverage of the non-formulary medication is only based upon the physician’s and/or member’s unwillingness to change to a formulary alternative, the request will not be considered.
If you have any questions, please contact MedImpact at 855-873-8739 to speak with a representative.