Pharmacy
Minnesota Health Care Programs (State Medical Assistance Programs)
Effective January 1, 2024, Navitus is the Pharmacy Benefit Manager (PBM) for all UCare members.
Through December 31, 2023, Express Scripts, Inc is the Pharmacy Benefit Manager (PBM) for all UCare members.
UCare Connect (SNBC) | MinnesotaCare (MnCare) | Prepaid Medical Assistance Program (PMAP)
Minnesota Senior Care Plus (MSC Plus)
Comprehensive Formularies:
UCare’s Minnesota Health Care Programs Formulary web page
FAQs about the Uniform Preferred Drug List for Providers
2023
ePA is the preferred method to submit Prior Authorization requests to Express Scripts for pharmacy benefit drugs. Providers may use ePA through ExpressPAth, Surescripts, CoverMyMeds or through the Electronic Health Record.
Prior authorization requests for medical drugs administered in a doctor's office will be reviewed by Care Continuum, a subsidiary of Express Scripts. See information in Medical Injectable Drug Prior Authorization Resources.
2024
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.
Prior authorization requests for medical drugs administered in a doctor’s office are reviewed by Care Continuum, a subsidiary of Express Scripts. See information under Medical Injectable Drug Prior Authorization Resources.
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 ExpressPAth Portal at www.express-path.com/. Providers can submit requests, check on the status of submitted requests, and submit an authorization renewal on the ExpressPAth 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.
2023
Pharmacy Benefit Prior Authorization
Express Scripts – UCare Individual & Family Plans and State Medical Assistance Programs
Phone: 1-877-558-7523
Fax: 1-877-251-5896
Express Scripts - Medicare, Medicare + Medical Assistance (dual eligibles)
Phone: 1-877-558-7521
Fax: 1-877-251-5896
Medical Injectable Drug Prior Authorization
Care Continuum, a subsidiary of Express Scripts
Online (ePA): ExpressPAth Portal at www.express-path.com/
Phone: 1-800-818-6747
Fax: 1-877-266-1871
UCare Clinical Services Intake
Fax: 612-884-2300
Specialty Pharmacy Contact Information
Fairview Specialty Pharmacy
Phone: 612-672-5260 or 1-800-595-7140 toll free
Fax: 1-866-347-4939
https://www.fairview.org/services/specialty-pharmacy
*exclusive network provider of specialty drugs for UCare Individual & Family Plans and State Medical Assistance Programs
Accredo
www.accredo.com
Mail Order Contact Information
Express Scripts Mail Order Pharmacy
Phone: 1-866-544-7950
Fax: 1-800-837-0959
ePrescribing: Express Scripts Home Delivery Pharmacy
2024
Pharmacy Benefit Prior Authorization - Navitus Health Solutions *New PBM for 2024*
State Medical Assistance Programs
- Phone: 1-833-837-4300
- Fax: 1-855-668-8553
Medical Injectable Drug Prior Authorization
Participating Providers Contact
Care Continuum, a subsidiary of Express Scripts:
- Online (ePA): ExpressPAth Portal at www.express-path.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
Specialty Pharmacy
Fairview Specialty Pharmacy (exclusive network provider of specialty drugs for UCare Individual & Family Plans and State Medical Assistance Programs)
- Phone: 612-672-5260 or 1-800-595-7140 toll free
- Fax: 1-866-347-4939
- Website: https://specialtypharmacy.fairview.org
Costco Mail Order Pharmacy *New for 2024*
- Phone: 1-800-607-6861
- Fax: 1-877-258-9584
- ePrescribing: Costco Mail Order Pharmacy #1348