Get the free 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria

This document outlines the prior authorization criteria for specific drugs covered under CIGNA Medicare Select Plus Rx, indicating details necessary for coverage determination through Medicare Parts

How to fill out 2011 cigna medicare select

How to fill out 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria

1. Gather the necessary patient information, including name, date of birth, and CIGNA member ID.
2. Identify the specific medication that requires prior authorization and its relevant details (e.g., dosage, frequency).
3. Review the prior authorization criteria for Formulary B and D to determine eligibility and necessary documentation.
4. Complete the required form, ensuring all sections are filled out accurately and thoroughly.
5. Attach any required medical records, clinical notes, or supporting documentation that justify the need for the medication.
6. Submit the completed prior authorization request to CIGNA via fax or online portal, following their submission guidelines.
7. Monitor the status of the prior authorization request and be prepared to provide additional information if requested by CIGNA.

Who needs 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria?

1. Patients enrolled in the 2011 CIGNA Medicare Select Plus Rx (HMO) plan who require access to specific medications on Formulary B or D that are subject to prior authorization.
2. Healthcare providers prescribing medications that fall under the prior authorization criteria to ensure that patients can obtain necessary medications.

People Also Ask about

Is a formulary exception the same as a prior authorization?

What is a Medicare Part D formulary (drug guide)? Medicare Part D helps cover the cost of prescription drugs and is offered to everyone who qualifies for Medicare. Each Part D plan has a list of drugs that are covered by the plan, called a Drug Formulary (or "Drug Guide").

What is the difference between generic and formulary?

A generic drug is identically equivalent to the brand name drug in form, safety, strength, quality and intended use. Although identical, generic drugs are substantially cheaper than their brand name counterparts. A formulary drug is a drug that is listed on a preferred drug list from your insurance carrier.

What is the formulary Part D?

There are two ways to get Medicare prescription drug coverage: Medicare Prescription Drug Plans. These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private Fee-for-Service (PFFS) plans, and Medicare Medical Savings Account (MSA) plans.

What does formulary mean for prescriptions?

A formulary is a list of generic and brand name prescription drugs covered by your health plan. Non-formulary drugs typically only include brand-name medications and come with high out-of-pocket expenses. Your health plan may only help you pay for the drugs listed on its formulary.

What is the most popular Part D drug plan?

Research Insight Compare the Best Medicare Part D Companies Company Best For Average Annual Deductible Aetna Best Overall Best for Customer Satisfaction $590 Wellcare Best for Low Premiums $590 AARP/UnitedHealthcare Best for Out-of-Pocket Costs $3091 more row

What is the formulary coverage data?

Formulary coverage is a list of generic or brand name drugs. Formulary coverage indicates prescriptions drugs for a specific treatment that are covered by a prescription drug plan or insurance company.

What is the difference between CMS Part B and D?

Medicare Part B only covers certain medications for some health conditions, while Part D offers a wider range of prescription coverage. Part B drugs are often administered by a health care provider (i.e. vaccines, injections, infusions, nebulizers, etc.), or through medical equipment at home.

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What is 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria?

The 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria outlines the specific requirements that must be met for certain medications to be approved for coverage under Medicare plans B and D, ensuring that prescribed drugs are medically necessary and clinically appropriate.

Who is required to file 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria?

Healthcare providers, including physicians and pharmacists, are required to file the 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria when prescribing medications that require prior authorization for coverage under the plan.

How to fill out 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria?

To fill out the 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria, providers should complete the form with patient information, medication details, and specific clinical rationale for the request, ensuring all necessary documentation and supporting evidence are included.

What is the purpose of 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria?

The purpose of the 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria is to manage medication use effectively, ensure patients receive appropriate treatments, and control healthcare costs by requiring justification for high-cost or non-formulary drugs.

What information must be reported on 2011 CIGNA Medicare Select Plus Rx (HMO) Formulary B vs D Prior Authorization Criteria?

The information that must be reported includes the patient's personal and insurance details, the prescribed medication, dosage information, diagnosis, supporting clinical rationale, and any previous treatment history relevant to the request.