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Insurance Plans - Ohio
Select the name of your insurance company to find out where to get forms
and to find contact information for your plan if you need to request prior
authorization or an exception.
This information was collected from the Web sites of the plans, and in
some cases from e-mails and phone calls to the plans. It is provided here
in an effort to make the information more conveniently available to you.
We do not endorse any particular plan and we are not responsible if any
plan has been inadvertently omitted from this list. We have not verified
this information. In addition, we cannot be responsible for ensuring that
the information is always up to date. Please notify
us if you are aware that any of the information provided has changed.
If you would like more detailed and current information, we suggest that
you consult the Medicare
Web site.
AETNA HEALTH INC
ANTHEM HEALTH PLANS OF KENTUCKY, INC.
COMMUNITY INSURANCE COMPANY
CONNECTICUT GENERAL LIFE INSURANCE COMPANY
COVENTRY HEALTH AND LIFE INS COMPANY
Where to Get Forms: Call 1-800-551-2694 and ask to have form faxed.
Phone # to request Prior Authorization: 1-800-551-2694
Phone # to request Exception: 1-800-551-2694
Fax #: Call 1-800-551-2694 and ask for fax number.
E-mail Address: Not Available
Updated: May 2006
FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY
Where to Get Forms: Call 1-800-551-2694 and ask to have form faxed.
Phone # to request Prior Authorization: 1-800-551-2694
Phone # to request Exception: 1-800-551-2694
Fax #: Call 1-800-551-2694 and ask for fax number.
E-mail Address: Not Available
Updated: May 2006
HEALTH PLAN OF THE UPPER OHIO VALLEY
Where to Get Forms: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Prior Authorization: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Exception: Not Available
Fax #: Not Available
E-mail Address: pharmcontracting@medco.com
Updated: May 2006
HOMETOWN HEALTH PLAN
Where to Get Forms: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Prior Authorization: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Exception: Not Available
Fax #: Not Available
E-mail Address: pharmcontracting@medco.com
Updated: May 2006
HUMANA HEALTH PLAN, INC.
KAISER FOUNDATION HP
Where to Get Forms: Call 1-877-645-1282 and ask for assistance.
Phone # to request Prior Authorization: Not Available
Phone # to request Exception: 1-877-645-1282
Fax #: Not Available
E-mail Address: janice.m.regan@kp.org
Updated: May 2006
MARQUETTE NATIONAL LIFE INSURANCE COMPANY
Where to Get Forms: Call 1-800-244-58000 and ask to have form sent.
Phone # to request Prior Authorization: 1-800-244-5800
Phone # to request Exception: 1-800-244-5800
Fax #: 513-881-6841
E-mail Address: JRoesch@pharmacare.com
Updated: May 2006
MCKINLEY LIFE INSURANCE COMPANY
MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK
Where to Get Forms: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Prior Authorization: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Exception: Not Available
Fax #: Not Available
E-mail Address: Not Available
Updated: May 2006
MEMBERHEALTH, INC.
MT. CARMEL HEALTH PLAN, INC.
PACIFICARE LIFE AND HEALTH INSURANCE COMPANY
PARAMOUNT CARE, INC
PENNSYLVANIA LIFE INSURANCE COMPANY
Where to Get Forms: Call 1-800-244-5800 and ask to have form sent.
Phone # to request Prior Authorization: 1-800-244-5800
Phone # to request Exception: 1-800-244-5800
Fax #: 513-881-6841
E-mail Address: JRoesch@pharmacare.com
Updated: May 2006
PROMEDICA LIFE INS D/B/A PARAMOUNT INS CO
Where to Get Forms: Call 1-877-665-6609 and ask to have form faxed.
Phone # to request Prior Authorization: 1-877-665-6609
Phone # to request Exception: 1-800-207-2568
Fax #: 1-866-617-6685
E-mail Address: medicareDHPMS@express-scripts.com
Updated: May 2006
QCC INS CO D/B/A AMERIHEALTH INS CO
QUALCHOICE HEALTH PLAN
Where to Get Forms: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Prior Authorization: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Exception: Not Available
Fax #: Not Available
E-mail Address: pharmcontracting@medco.com
Updated: May 2006
SILVERSCRIPT INSURANCE COMPANY
STERLING LIFE INSURANCE COMPANY
SUMMACARE INC.
UNICARE
UNITED AMERICAN INSURANCE COMPANY
Where to Get Forms: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Prior Authorization: Your pharmacist will receive information from the plan if your prescription is denied because of a coverage problem.
Phone # to request Exception: Not Available
Fax #: Not Available
E-mail Address: pharmcontracting@medco.com
Updated: May 2006
UNITED HEALTHCARE INSURANCE COMPANY
Where to Get Forms: Call 1-877-665-6647 and ask to have form faxed.
Phone # to request Prior Authorization: 1-877-665-6647
Phone # to request Exception: 1-800-207-2606
Fax #: 1-866-617-6723
E-mail Address: provider.relations@walgreens.com
Updated: May 2006
WELLCARE HEALTH PLANS
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