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To learn about or to enroll in 2016 plans, click here.
To learn about 2015 plans, see below.

Hours: 8:00 AM - 8:00 PM 7 days a week
Sales: 1-855-633-4198
Members: 1-800-204-1002
TTY: 711

Formulary and Drug Pricing Tool

Medicare Prescription Drug Plans


A formulary is a list of drugs selected by Care Improvement Plus in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. The formulary consists of both generic and brand name drugs. Care Improvement Plus will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a Care Improvement Plus network pharmacy, and other plan rules are followed. Click here to view the Care Improvement Plus online formulary.

If you would like a copy of the Drug List, call Member Services at 1-800-711-1656 (TTY: 711) 7 days a week, 8:00 am - 8:00 pm for more information.

Click on the link below to view the most current list of drugs covered on Care Improvement Plus’ formulary for the following plans: Gold Rx (PPO SNP), Gold Rx (Regional PPO SNP), Medicare Advantage (PPO), Medicare Advantage (Regional PPO).

2015 English Formulary

2015 Spanish Formuary

Click on the links below to view the most current list of drugs covered on Care Improvement Plus’ formulary for the following plans: Dual Advantage (PPO SNP), Dual Advantage (Regional PPO SNP), Silver Rx (PPO SNP), Silver Rx (Regional PPO SNP).

2015 English Formulary

2015 Spanish Formulary

Click on the links below to find out more information about the criteria for drugs that require a prior authorization, step therapy, or have a quantity limit.

Prior Authorization Criteria
Step Therapy Criteria

Ways to Save on Drug Costs

The Pharmacy Saver™ program was created to help members save money on many common prescription drugs. Hundreds of generic drugs now cost as low as $1.50. Simply use one of the participating pharmacies and show your member ID card.

Look up qualifying drugs, prices and participating pharmacies - United Pharmacy Saver

Upcoming Changes to Care Improvement Plus' Formulary

Care Improvement Plus may add or remove drugs from the formulary during the year. If we remove drugs from our formulary, add prior authorization(s), quantity limits and/or step therapy restriction(s) on a drug, and/or move a drug to a higher cost-sharing tier, we will notify you of the change at least 60 days before the date that the change becomes effective. However, if the Food and Drug Administration (FDA) deems a drug on our formulary to be unsafe or the drug's manufacturer removes the drug from the market, in which case we will immediately remove the drug from our formulary and notify you of the change.

Formulary additions
Formulary deletions

Mail Order

For obtaining prescription drugs by mail, use one of the following
Pharmacy Mail Order Form (English)
Pharmacy Mail Order Form (Spanish)

Extra Help (Low Income Subsidy)

You may qualify for extra help paying your monthly drug plan premium and a portion of your prescription drug costs – and even prescription drug coverage through the coverage gap.

Extra help is provided by Medicare to pay prescription drug costs for people who meet specific income and resource limits. Resources include your savings and stocks, but not your home or car. If you qualify, you will get help paying for your Medicare drug plan’s monthly premium, yearly deductible, and prescription copayments. In most cases, if you get extra help, you won’t pay a premium. If you qualify for extra help, you won’t have a coverage gap either.

To see if you qualify, call: 1-800-MEDICARE (1-800-633-4227), TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Administration at 1-800-772-1213 between 7:00 am and 7:00 pm, Monday through Friday, TTY/TDD users should call 1-800-325-0778; or your State Medicaid Office.

Care Improvement Plus also contracts with Social Services Coordinators (SSC) who can help you find assistance with drug costs if you qualify. You can call SSC at 866-868-2155.

If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. The amount of extra help you get will determine your total monthly plan premium as a member of our Plan.

Part D Vaccine

If you have been prescribed a vaccine that is covered under Medicare and was administered by your physician, your physician may submit the claim to OptumRx for reimbursement and collect only your copay by submitting the Vaccine Claim form to:

P.O. Box 29046
Hot Springs, AR 71903

Upon receipt of the HCFA 1500 from the physician, OptumRx will process the paper claim and return reimbursement to the physician's office with an explanation of payment including the beneficiary's cost share for collection.

Additional Information:

  • You can get additional information from the Centers for Medicare and Medicaid Services by calling 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048), which is the national Medicare help line, 24 hours a day, 7 days a week.
  • As a Care Improvement Plus member, you may request the aggregate number of Care Improvement Plus grievances, appeals and exceptions, by calling Member Services.

This page was last updated on: 12/31/2013 3:06:42 PM

Copyright © 2006 - 2015 Care Improvement Plus

Additional Information Links State Health Plan Links
Providers Support
Caregivers Support
Regional PPO Plans
Medicaid / Medicare Special Needs Plans
Medicare Advantage Plans
Medicare Part D Coverage
Medicare Prescription Drug Plans
Medicare Coverage - Diabetes
Medicare Coverage - Heart Failure
Arkansas Medicare Health Plans
Georgia Medicare Health Plans
Illinois Medicare Health Plans
Indiana Medicare Health Plans
Iowa Medicare Health Plans
Missouri Medicare Health Plans
Nebraska Medicare Health Plans
New Mexico Medicare Health Plans
North Carolina Medicare Health Plans
South Carolina Medicare Health Plans
Texas Medicare Health Plans
Wisconsin Medicare Health Plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare. You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or by another third party.

The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Medicare evaluates plans based on a 5-Star rating system. Star ratings are calculated each year and may change from one year to the next.

Eligible beneficiaries must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances, and quantity and restrictions may apply. It may cost more to get care from out–of–network providers, except in an emergency. If there isn’t a network provider available for you to see, you can go to an out–of–network provider but still pay the in–network amounts. The health providers in our network can change at any time.

To be eligible for a Care Improvement Plus Regional PPO plan you must be a Medicare beneficiary living in Arkansas, Georgia, Missouri, South Carolina, or Texas and have both Medicare Part A and Part B to enroll.

To be eligible for a Care Improvement Plus Local PPO plan you must be a Medicare beneficiary living in select counties of: Arkansas, Georgia, Illinois, Indiana, Iowa, Missouri, Nebraska, New Mexico, North Carolina, South Carolina, Texas or Wisconsin and have both Medicare Part A and Part B to enroll.

To be eligible for a Care Improvement Plus Chronic Conditions Special Needs Plan, you must have diabetes and/or heart failure and/or, cardiovascular disorder. This plan is available to anyone having a qualifying chronic care condition. Members may enroll in the plan only during specific times of the year. Contact Care Improvement Plus for more information. If you have diabetes, heart failure, cardiovascular disorder or Medicaid/Low Income Subsidy, you may qualify to enroll in a Care Improvement Plus Special Needs Plan ANYTIME of the year by exercising a “Special Election Period.

To be eligible for a Care Improvement Plus Dual Advantage Plan, you must be enrolled in state Medicaid and be a dual eligible beneficiary whom the State holds harmless for Part A and Part B cost sharing. This plan is available to anyone who has both medical assistance from the state and from Medicare. If you are a full benefit dual beneficiary and your Part B premium is paid for by the State, you will not be responsible for paying your Part B premium. Premiums, copays, co-insurance and deductibles may vary based on the level of extra help you receive. Please contact the plan for further details.

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call:

  • 1–800–MEDICARE (1–800–633–4227). TTY users should call 1–877–486–2048, 24 hours a day/7 days a week;
  • The Social Security Office at 1–800–772–1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1–800–325–0778; or
  • Your State Medicaid Office.

People with limited incomes may qualify for Extra Help to pay their prescription drug costs. If eligible, Medicare could pay for 75% or more of your drug costs including monthly prescription drug premiums, annual deductibles, and coinsurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office, or call Social Security at 1– 800–772–1213.TTY users should call 1–800–325–0778. You can also apply for Extra Help online at www.socialsecurity.gov/prescriptionhelp. If you qualify for Extra Help with your Medicare prescription drug coverage costs, Medicare will pay all or part of your plan premium. If Medicare pays only a part of this premium, we will bill you for the amount that Medicare doesn’t cover.

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