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.
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.