The management of outpatient prescription drugs is an integral part of the medical management program to improve the health and well-being of our members. Prescriber and member involvement is critical to the success of the pharmacy program.

 

To help your patients get the most out of their pharmacy benefit please be cognizant of the following guidelines when prescribing:

 

 

Additions and Exceptions to the Preferred Drug List

 

Generic Medications

 

Injectable, Infusion Services

 

Coverage Limitations

 

Step Therapy Programs

 

Over the Counter (OTC) Medications

 

Pharmacy Lock-In Program

 

Patient Co-payments

 

Drug Evaluation Review Process

 

Pharmacy Management- Network Improvement Program

 

 

Accu-Chek Meter Form

 

Bayer Meter Form

 

Injectable-Infusion Form

 

Coverage Determination Request Form

 

Synagis Form

 

 

The 'Ohana Health Plan Pharmacy Department telephone number is 1-888-505-1198.

For detailed information about pharmacy services, refer to the Pharmacy section of the 'Ohana Provider Manual.