Pharmacy Benefit Manager — ClearScript

Avera Health Plans currently contracts with ClearScript (NPS) to provide prescription drug coverage. Self-funded groups may choose other pharmaceutical vendors.

The following links are available to members:

• 2012 Drug Formulary
• 3-Tier Formulary Look Up
• 4-Tier Formulary Look Up

• About ClearScript
• ClearScript Pharmacy Locator
• ClearScript Drug Information and Pricing Note: This does not reflect formulary status at this time.
• Mail Order Information. Mail order prescriptions will be processed by ClearScript's mail order pharmacy, Fairview Mail Service Pharmacy. Members will need to complete the Mail Order Form and submit to ClearScript to avoid disruption to their service. A letter was mailed in November to all members currently receiving mail order prescriptions.
• Medications Requiring Prior Authorization  
• Self-Injectable Medications List
• Specialty Medication List
• Step Therapy Programs

The above links are provided to you as general reference materials.  Not all plans or members utilize these pharmacy programs.  These references are not a guarantee of coverage.  Benefit determinations are based on the member’s contractual agreement.  Exclusions, limitations or exceptions may apply.  Benefits vary based on contract, and individual member benefits must be verified.