Pharmacy
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Medical providers: Effective Feb. 1, 2008, pharmacy services and some drug-related supplies for Children's Community Health Plan members will be reimbursed by fee-for-service. This includes medication that is obtained at a retail pharmacy and/or is self-administered. Download the list of these drug-related supplies.
For information on covered medications and prior authorizations, visit the state pharmacy Web site at http://dhfs.wisconsin.gov/medicaid/pharmacy/index.htm.
Coverage of specialty medication provided in a clinic or office setting
Selected medications provided in an office or clinic setting require prior authorization to be eligible for coverage. The individual Prior Authorization Forms are listed below and include the criteria needed for approval. These should be printed, completed and faxed to Children's Community Health Plan by the physician to request review for coverage determination. If the medication is self-injected, it should be obtained at a retail pharmacy and reimbursed by fee-for-service.
Children's Community Health Plan reserves the right to review and amend/update these guidelines as needed.
Information provided on this Web site and any other Children's Community Health Plan Web site is not intended or implied to be a substitute for professional medical advice. If you have specific medical needs, please consult your health care professional. |
