Pharmacy
Medicare Advantage Plans
Effective January 1, 2024, Navitus is the Pharmacy Benefit Manager (PBM) for all UCare members.
UCare Medicare Plans | UCare Medicare Group Plans | UCare Advocate Plans | EssentiaCare |
UCare Medicare Plans with M Health Fairview & North Memorial | UCare Your Choice Plans
2024 Comprehensive Formularies:
2024 Prescription Drug Coverage:
UCare Medicare, UCare Medicare with Fairview & North Memorial Plans
ePA is the preferred method to submit Prior Authorization requests to Navitus for pharmacy benefit drugs. Providers may use ePA through Surescripts, CoverMyMeds or the Electronic Health Record.
For info on Medical Injectable Drug Prior Authorization requests, see "Medical Injectable Drug Prior Authorization Resources" on the Pharmacy page.
See the Medical Injectable Drugs requiring prior authorization.
Review Medical Drug Policies.
Participating providers can submit prior authorization, authorization adjustment and pre-determination requests to Care Continuum one of the following ways:
- Online (ePA) via the OnePA Portal at www.EviCore.com. Providers can submit requests, check on the status of submitted requests, and submit an authorization renewal on the OnePA Portal. The site also provides 24/7 access, potential for real-time approvals and email notifications once a decision is reached.
- Fax an authorization request form to Care Continuum at 1-877-266-1871.
- Call Care Continuum at 1-800-818-6747.
Non-participating and MultiPlan providers can submit prior authorization, authorization adjustment and pre-determination requests to UCare one of the following ways:
- Fax an authorization request form to UCare Clinical Pharmacy Intake at 612-617-3948.
- By mail to UCare, Attn: Pharmacy at P.O. Box 52, Minneapolis, MN 55440-0052.
Providers that receive a claim denial will continue to work through the provider claims appeal process using the Provider Claim Reconsideration Request Form.
Prescription Drug Transition Policy (New 11/29/2023)
Pharmacy Benefit Prior Authorization - Navitus Health Solutions *New PBM for 2024*
Medicare and Medicare + Medical Assistance (dual eligibles)
- Phone: 1-833-837-4300
- Fax: 1-855-668-8552
Medical Injectable Drug Prior Authorization
Participating Providers Contact
Care Continuum, a subsidiary of Express Scripts:
- Online (ePA): OnePA Portal at www.EviCore.com
- Phone: 1-800-818-6747
- Fax: 1-877-266-1871
Non-Participating Providers Contact
UCare Clinical Pharmacy Intake
- Phone: 612-676-6504
- Fax: 612-617-3948
Fairview Specialty Pharmacy
- Phone: 612-672-5260 or 1-800-595-7140 toll free
- Fax: 1-866-347-4939
- Website: https://specialtypharmacy.fairview.org
Lumicera Specialty Pharmacy *New for 2024*
- Phone: 1-855-847-3554
- Fax: 1-855-847-3558
- Website: www.lumicera.com
Costco Mail Order Pharmacy *New for 2024*
- Phone: 1-800-607-6861
- Fax: 1-877-258-9584
- ePrescribing: Costco Mail Order Pharmacy #1348