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Medicare

Pharmacy Overview for Providers Home > Medicare 

Information applicable to Medicare Part D members

Pharmacy Resources

2016 Resources

Preferred Drug Lists (Formularies)

2016 Part D Closed Formulary (Medica Prime Solution®) – (PDF)


Medication Request and Exception Forms

Minnesota Prescription Drug Prior Authorization (PA) Requests and Formulary Exceptions Form (PDF)


Part D Forms

Prime Solution® Coverage Determination Request Form (Part D prior authorization)

Prime Solution® Coverage Redetermination Request Form (Part D redetermination)

Adverse drug reaction reporting form (MedWatch form) »


Prior Authorization

Prime Closed Formulary (PDF)


Step Therapy

Prime Closed Formulary (PDF)

Mail Order Pharmacy 

Medica offers pharmacy mail order through Fairview Mail Service Pharmacy. Members may receive a 90-day supply of their medication through the mail with a 90-day prescription, with no shipping or handling fees. Members can register for this service by phone or online.

Visit Fairview Mail Service Pharmacy for member information about using this service » 

Coming Soon

Starting Jan. 1, 2018, CVS Caremark Mail Service Pharmacy will be the new provider of prescription mail services for Commercial Plan members members, replacing Fairview Mail Service Pharmacy. Members may receive a 90-day supply of their medication through the mail, with no shipping or handling fees.

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