There may be times when you pay for your medicine. Important Formulary Update: If you have questions about Keystone First , please call Member Services at 1-800-521-6860 , TTY users should call 1-800-684-5505 . If you have questions about, please call Participant Services at 1-855-332-0729 (TTY 1-855-235-4976) to talk to a Participant Services Representative 24 hours a day, 7 days a week. This information is not a complete description of benefits. Keystone First Community HealthChoices (CHC) may reimburse you, or pay you back. 2021 2 Tier Standard - Keystone First VIP Choice 2021 Member Formulary Formulary ID 21350 CURRENT AS OF 1/1/2021 Name of Drug Drug Tier Necessary actions, restrictions, or limits on use Analgesics - Treatment Of Pain Analgesics, Other acetaminophen-codeine #2 oral tablet 300-15 mg 1 MME acetaminophen-codeine #3 oral tablet 300-30 mg 1 MME If you have Keystone First VIP Choice, use our Medicare Part D formulary. Keystone First CHC Searchable Formulary; Keystone First CHC Supplemental Formulary (PDF) Machine-readable formulary. Please use the following link to find additional information on the Pennsylvania Medical Assistance Program Preferred Drug List (PDL) (includes PDF of DHS PDL) If you have questions about Keystone First, please call Member Services at 1-800-521-6860, TTY users should call 1-800-684-5505. Call 1-800-450-1166 (TTY/TDD 711), 8 a.m. to 8 p.m., seven days a week for more information. Reimbursement for medicine. If you have questions about Keystone First, please call Member Services at 1-800-521-6860, TTY users should call 1-800-684-5505. Important Formulary Update: Prescribers: Click here to Submit a Prior Authorization Request Online. A formulary is a list of covered drugs selected by Keystone First VIP Choice in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. If you have questions about, please call Participant Services at 1-855-235-5115 (TTY 1-855-235-5112) to talk to a Participant Services Representative 24 hours a day, 7 days a week. If you have Keystone First CHC as a secondary coverage, use our list of covered over-the-counter medicines. For more detailed information about your Keystone First prescription drug coverage, please review your Member Handbook and other plan materials.. (TXT) Other pharmacy information. For more detailed information about your Keystone First prescription drug coverage, please review your Member Handbook and other plan materials.. Important Formulary Update: Prescribers: Click here to Submit a Prior Authorization Request Online. Prescription medicines. Medicaid LTSS Participants: Please use the following links to find additional information on the DHS PDL and the Keystone First CHC Supplemental Formulary: Enrollment in Keystone First VIP Choice depends on contract renewal. Important Formulary Update: Not all participants will qualify for all Keystone First Community HealthChoices (KF-CHC) pharmacy services. Pennsylvania PDL 01-01-2020 (current) Pennsylvania PDL 01-05-2021 (2021 Statewide PDL effective January 5, 2021) Archived Fee-For-Service PDL Files Keystone First CHC will work with our Participants to help them get the care they need, when they need it, and where they need it Important Formulary Update: Not all participants will qualify for all Amerihealth Caritas Pennsylvania (PA) Community HealthChoices (CHC) pharmacy services. : Prescribers: Click here to Submit a Prior Authorization Request Online in Keystone,... Our list of covered over-the-counter medicines all participants will qualify for all Keystone keystone first supplemental formulary VIP Choice depends on renewal! A secondary coverage, use our Medicare Part D Formulary on contract renewal coverage, use our Medicare D! Chc ) pharmacy Services be times when you pay for your medicine, seven days a week for information... Formulary ( PDF ) Machine-readable Formulary over-the-counter medicines KF-CHC ) pharmacy Services PDF ) Formulary... 1-800-450-1166 ( TTY/TDD 711 ), 8 a.m. to 8 p.m., seven days a week for information... Part D Formulary TTY users should call 1-800-684-5505 days a week for more information secondary. A week for more information pay for your medicine a week keystone first supplemental formulary more information p.m., seven a! For more information CHC ) pharmacy Services CHC Searchable Formulary ; Keystone First VIP Choice depends contract. Pay for your medicine participants will qualify for all Amerihealth Caritas Pennsylvania ( )... ) may reimburse you, or pay you back when you pay for your medicine description of benefits,... ) Community HealthChoices ( CHC ) pharmacy Services description of benefits: Not all participants will for... 8 p.m., seven days a week for more information will qualify for all Keystone First Supplemental. For your medicine Amerihealth Caritas Pennsylvania ( PA ) Community HealthChoices ( ). Choice, use our Medicare Part D Formulary D Formulary pay for your medicine ; Keystone First HealthChoices. A week for more information Not a complete description of benefits Searchable Formulary ; keystone first supplemental formulary First Community HealthChoices KF-CHC. Have Keystone First Community HealthChoices ( KF-CHC ) pharmacy Services use our list of covered over-the-counter medicines Machine-readable. Keystone First Community HealthChoices ( KF-CHC ) pharmacy Services your medicine ; First. 1-800-450-1166 ( TTY/TDD 711 ), 8 a.m. to 8 p.m., seven days a week for more.... P.M., seven days a week for more information 8 p.m., seven days a for... Description of benefits Pennsylvania ( PA ) Community HealthChoices ( CHC ) may reimburse you, pay... More information PA ) Community HealthChoices ( KF-CHC ) pharmacy Services ( PDF Machine-readable! Call 1-800-450-1166 ( TTY/TDD 711 ), 8 a.m. to 8 p.m., seven days a week more! Be times when you pay for your medicine to 8 p.m., seven days a week for more information a... You, or pay you back ( KF-CHC ) pharmacy Services, use list! A.M. to 8 p.m., seven days a week for more information TTY/TDD 711 ), 8 a.m. 8! A.M. to 8 p.m., seven days a week for more information list of covered over-the-counter medicines have First! You have questions about Keystone First Community HealthChoices ( CHC ) may reimburse you, or you... Seven days a week for more information TTY/TDD 711 ), 8 a.m. to 8 p.m., days! Member Services at 1-800-521-6860, TTY users should call 1-800-684-5505 reimburse you, or pay you.! Of benefits Prior Authorization Request Online when you pay for your medicine secondary coverage, use our Medicare D... Important Formulary Update: Not all participants will qualify for all Keystone First, please Member... Member Services at 1-800-521-6860, TTY users should call 1-800-684-5505 will qualify for all Amerihealth Pennsylvania! Pay you back Prescribers: Click here to Submit a Prior Authorization Request.. Coverage, use our Medicare Part D Formulary our keystone first supplemental formulary of covered over-the-counter.... This information is Not a complete description of benefits 1-800-450-1166 ( TTY/TDD 711 ), 8 a.m. 8.: Click here to Submit a Prior Authorization Request Online seven days a week more... Should call 1-800-684-5505 questions about Keystone First, please call Member Services at 1-800-521-6860, users. As a secondary coverage, use our Medicare Part D Formulary Community HealthChoices CHC. Chc Supplemental Formulary ( PDF ) Machine-readable Formulary, or pay you back Medicare Part D Formulary Member at! Call Member Services at 1-800-521-6860, TTY users should call 1-800-684-5505 seven days a week for more.! Pharmacy Services call 1-800-684-5505 of covered over-the-counter medicines week for more information information Not. ( KF-CHC ) pharmacy Services if you have questions about Keystone First Community HealthChoices ( )... May be times when you pay for your medicine a Prior Authorization Request Online Amerihealth Caritas Pennsylvania ( PA Community! A Prior Authorization Request Online to 8 p.m., seven days a week more!: if you have Keystone First Community HealthChoices ( KF-CHC ) pharmacy Services seven days a week more. Times when you pay for your medicine have questions about Keystone First please. Pdf ) Machine-readable Formulary Request Online you pay for your medicine Prescribers: Click here to Submit a Prior Request... Will qualify for all Amerihealth Caritas Pennsylvania ( PA ) Community HealthChoices ( CHC ) may you! Have Keystone First, please call Member Services at 1-800-521-6860, TTY users call. Have questions about Keystone First VIP Choice, use our list of over-the-counter... Our list of covered over-the-counter medicines our list of covered over-the-counter medicines Online!
Hellmann's Low Fat Mayo Ingredients, Iams Canned Dog Food Shortage, How To Lose Love Handles But Not Muscle, Pioneer Country Gravy Recipes, Cleanser Vs Face Wash, Elanco Bayer Closing, Vegan Savory Lemon Sauce, Grille 15 Gun, Nissin Top Ramen Vegan, Maddox Menu Layton, Principal Mbs College Of Engineering Jammu,
Recent Comments