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Frequently Asked Prescription Drug Questions

  • Where can I fill my prescriptions?

  • How do I fill a prescription at a network pharmacy?

  • Can the list of network pharmacies change?

  • Can I fill a prescription at an out-of-network pharmacy?

  • How do I submit a paper claim to request reimbursement?

  • What prescription drugs are covered?

  • Are vaccines covered?

  • What if I am prescribed a drug that is not on the formulary or is on the formulary but its use is restricted?

  • How might the formulary change during the year?

  • How do I request a coverage determination (e.g., prior authorization) or formulary exception?

  • How do I appeal a decision not to cover a drug that my provider or I requested?

  • Which drug management programs does CareOregon Advantage offer?

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CareOregon Advantage Plus is an HMO-POS SNP with a Medicare/Medicaid contract.  Enrollment in CareOregon Advantage Plus depends on contract renewal. 

CareOregon Advantage Star is an HMO plan with a Medicare contract. Enrollment in CareOregon Advantage Star depends on contract renewal.

   Page last updated: October 1, 2017   
   H5859_4006_CO_2018 CMS APPROVED  

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