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Benefits

Who is Eligible?

All active CareLink members who are seen by providers in contracted CareLink clinics are eligible to participate in the Prescription Benefits Program. Costs of prescriptions are dependent upon members’ income levels and are determined at the time of enrollment.

Where Can Prescriptions be Filled?

CareLink can only help members with prescriptions when they are filled at a University Health System pharmacy. A limited number of medications are also available at the CentroMed South Park Pharmacy at 6315 South Zarzamora for members seen at that clinic. Click here to download the Prescription Mail Out Request Form.

What Drugs are Available?

University Health System (UHS) utilizes an evidence-based formulary of drugs selected by our practicing physicians and clinical pharmacists. The CareLink subsidized (covered) medication list is derived from the UHS formulary.  These medications are available to active CareLink members for minimal co-payments. The list is updated every month  and it is accessible to all providers. Since some medications are only subsidized by CareLink if certain conditions are met and some are only available through Medication Assistance Programs (MAP), it is difficult to create a simple, all-inclusive list for members. An abbreviated list of commonly prescribed, subsidized medications is available.

What if a Medication is Not Subsidized by CareLink?

Unfortunately, CareLink cannot cover all medications. Medications that are not subsidized can be purchased at full price if stocked at University Health System pharmacies or they can be obtained through retail pharmacies at the members’ expense. CareLink understands that treatment approaches will change and exceptions may be necessary. A non-subsidized formulary request process is available to providers and is designed to evaluate non-formulary needs based on eligibility status, cost effectiveness, availability, and medical appropriateness. These conditions are determined on an individual basis. Only providers may submit non-subsidized formulary requests.

What is the Medication Assistance Program (MAP)?

The MAP is available to assist members in obtaining medications through pharmaceutical manufacturer programs. Most pharmaceutical manufacturers provide medications to individuals with little or no prescription drug coverage at no charge. Each pharmaceutical manufacturer has different criteria for eligibility, but many CareLink members will qualify. Although some medications are not covered by CareLink, many are made available through the MAP. The MAP advocates will prepare all applications and forward to CareLink providers for signatures. The pharmacies can help members determine if drugs ordered are subsidized, can be temporarily subsidized, or are only available through the MAP. Some medications may take up to four to six weeks from the time the MAP advocates order the drugs and the day they are received from the pharmaceutical manufacturers.

Subsidized Medications

For an abbreviated list of subsidized medications, click here.  Prescription formularies continually change to reflect the most recent advances in drug therapy. Therefore, this list is not all-inclusive and does not guarantee coverage by CareLink.

Please note that many additional medications are available when Pharmacy and Therapeutics (P & T) and/or CareLink prescribing restrictions are followed and/or when obtained through the Medication Assistance Program (MAP).

Medication Assistance Program

For an abbreviated list of medications available through the Medication Assistance Program (MAP), click here.

Please note that this is an abbreviated list of available medications.

 

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