Pharmacy

Information by UCare Plan

 

UCare Individual & Family Plans

 

Commercial products for individual and family coverage available through MNsure, including UCare Choices and UCare Choices with Fairview

Medicare Programs

 

 

UCare for Seniors (UFS), Group UCare for Seniors, UCare Medicare Plans, UCare Medicare Plans with Fairview and North Memorial, EssentiaCare.

Medicare + Medical Assistance

 

UCare Connect + Medicare and Minnesota Senior Health Options (MSHO)

State Medical Assistance Programs

 

UCare Connect (Special Needs BasicCare), Minnesota Senior Care Plus (MSC Plus), MinnesotaCare (MnCare), Prepaid Medical Assistance Program (PMAP)

 

Resources & Information

 

Electronic Prior Authorization (ePA): 

ePA is the preferred method to submit Prior Authorization requests to Express Scripts. Providers may use ePA through Express Scripts, Surescripts, CoverMyMeds or through the Electronic Health Record.

The Pharmacy and Therapeutics Committee, a group of practicing physicians and pharmacists, meets up to six times per year to recommend medication inclusion or exclusion to our formularies. The Pharmacy and Therapeutics Committee evaluates drugs based on clinical evidence and efficacy (drug monographs, peer reviewed literature, compendia resources), therapeutic guidelines, medication safety and comparable data to other therapeutic alternatives. This committee reviews all new drugs approved by the FDA, new generics, new dosage forms, new indications as well as regular therapeutic class reviews and annual review of all utilization management criteria.

November 2018 Decisions
September 2018 Decisions
June 2018 Decisions
March 2018 Decisions
January 2018 Decisions



 

Pharmacy Benefit Prior Authorization

Express Scripts - State Medical Assistance Programs, 2018 UCare Choicesand 2019 UCare Individual & Family Plans
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

UCare Clinical Services Intake - State Medical Assistance Programs
Fax: 612-884-2300
 
UCare Clinical Services - Medicare, Medicare & Medical Assistance (dual eligibles), 2018 UCare Choices, and 2019 UCare Individual & Family Plans
Fax: 612-884-2094 or 1-866-610-7215 toll free
 

Specialty Pharmacy Contact Information

Fairview Specialty Pharmacy
Phone: 612-672-5260 or 1-800-595-7140 toll free
Fax: 1-866-347-4939
* exclusive network provider of specialty drugs for 2018 UCare Choices, 2019 UCare Individual & Family Plans, and State Medical Assistance Programs
 
Accredo
 

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   
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If you have other questions, contact the Provider Assistance Center:

612-676-3300 or 1-888-531-1493
Hours:  8 a.m. to 5 p.m.,  Monday through Friday

Newsletters & Alerts

 

See Full Provider News Library

Provider Portal Unavailable

We are currently experiencing a technical issue on our provider portal. We are working on a resolution. We apologize for the inconvenience.

 

 

 

 

 

 

 

 

UCare Provider Manual Has Been Updated

2018 Provider Manual updates were made to Working with UCare's Delegated Business Services  Claims & Payment, Clinical Practice Guidelines, Member Appeals and Grievances, Home & Community Based Services, Public Health and Transportation Services. A change table in the Appendix links to specified changes in the manual. 
 

See the Provider Manual

 

 

Provider Assistance Center Phone Update

Our phone service is working, we’re continuing to monitor for any ongoing issues, please be aware we anticipate higher volumes as people catch up so we may experience longer wait times, especially on Monday. For faster assistance, please use the Provider Portal for claims, eligibility and authorization inquiries. We apologize for the inconvenience.