

Pharmacy Resources
Payer Sheet:
Drug Coverage:
Prior Authorization:
Best Available Evidence (BAE) Policy:
Pharmacy Support:
Drug Coverage:
Prior Authorization:
Best Available Evidence (BAE) Policy:
Pharmacy Support:
- Call 1-877-279-0372
Enrollment Forms:
*For plans starting Jan. 1st 2009
Applicants should keep a copy for their records.



