Pharmacy and prescription drug resources
Our Pharmacy Department wants to help you use your Medicare Part D benefit to your advantage. Check our drug list (formulary) to see if your prescription is covered. Find important forms that will help you and/or your provider get the service you need.
CareOregon Advantage Drug List (Formulary)
Customer Service:
If you need any help from our Pharmacy team, call us at 503-416-4279 or toll-free 888-712-3258, TTY 711. Our hours are: October 1 through March 31, 8 a.m. to 8 p.m. daily; and April 1 through September 30, 8 a.m. to 8 p.m., Monday-Friday.
Medicare Part D coverage determinations, formulary exceptions and appeals
Coverage determinations and formulary exceptions
If you, your representative or your health care provider want to request a coverage determination or a formulary exception, here are a few different ways you can make the request.
- Call: 503-416-4279, toll-free 888-712-3258 or TTY 711
- Fill out a Prior Authorization / Formulary Exception form and fax, mail or email the completed form to us
- Fax: 503-416-8109
- Write: CareOregon Advantage
Attn: Pharmacy
315 SW Fifth Ave
Portland, OR 97204 - Email: partdparequests@careoregon.org
- Use our secure online coverage determination/formulary exception form
You may also use the Request for Prescription Drug Coverage Determination form provided by Medicare. Find your preferred language of this form below:
If you are in hospice and you are on a drug that is not covered by your hospice program, your prescriber or hospice program can use the Hospice Prior Authorization form.
For more information about coverage determinations and formulary exceptions, see "How do I request coverage for a drug that is not covered or one that's covered, but with restrictions?" on our Prescription Drugs FAQ page.
Appeals
There are several ways you, your representative or your doctor can request an appeal:
- Call: 503-416-4279, toll-free 888-712-3258 or TTY 711
- Fill out a Request for Redetermination form and fax, mail or email the completed form to us. Find your preferred language of this form below:
- Fax: 503-416-1428
- Write: CareOregon Advantage
Attn: Pharmacy
315 SW Fifth Ave
Portland, OR 97204 - Email: partdparequests@careoregon.org
- Use our secure online appeal form to send us your appeal
For more information on Part D appeals, read "How do I appeal a decision not to cover a drug that my provider or I requested?" on the Prescription Drugs FAQ page.
Pharmacy transition
We want to make sure your transition to our health plan or a new year is as smooth as possible! Please read our transition policy for more information.
