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West Virginia Medicaid Provider Newsletter 350 Capitol Street, Room 251, Charleston, WV 25301Qtr. 2 2017Pharmacy Benefits Moving from Managed Care to FeeForService Effective July 1, 2017, the pharmacy
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To fill out pharmacy benefits moving from, follow these steps:
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Gather all necessary information such as your prescription details, insurance information, and personal details.
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Contact your current pharmacy benefits provider and request a pharmacy benefits moving form.
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Fill out the form accurately and completely. Provide all required information, including your name, address, contact details, and new pharmacy benefits provider information.
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Attach any supporting documentation required, such as a copy of your insurance card or prescription documents.
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Double-check the form to ensure all information is correct and legible.
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Submit the filled-out form to your current pharmacy benefits provider through their designated channels, which may include mail, fax, or online submission.
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Keep a copy of the filled-out form for your records.
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Follow up with your current pharmacy benefits provider to confirm receipt and processing of the form.
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Once your pharmacy benefits moving request is processed, verify the effective date of the new pharmacy benefits and any changes in coverage or copayments.
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Start utilizing your pharmacy benefits with the new provider as per the effective date.

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Pharmacy benefits moving from is needed by individuals who:
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- Experience changes in insurance coverage or an employer switch, necessitating a change in pharmacy benefits provider.
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- Want to consolidate their healthcare services or prefer a pharmacy benefits provider that aligns with their other healthcare providers.
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Pharmacy benefits are moving from one provider to another.
The pharmacy/provider that is sending or receiving the benefits.
You can fill out a pharmacy benefits moving form online or through a paper form provided by the insurance company.
The purpose is to ensure a smooth transition of pharmacy benefits from one provider to another.
The information that must be reported includes patient demographics, prescription details, and insurance information.
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