Pharmacy management

Pharmacy Management

Overview of Prescription Drug Management Plan
Samaritan Health Plans provides all members with medication review services upon request. Members can meet with the SHPO Clinical Pharmacist via an appointment at our Avery Square offices or by phone or email. The purpose of this service is to answer member questions about medications, less costly alternatives and other pharmaceutical issues

Samaritan Health Plans maintains a Committee composed of physicians and pharmacists whose purpose is to review evidenced based, scientific evidence and decide which medications should be added or deleted from our formularies. The Committee meets every other month or as needed to fulfill this important function.

Prescribing medications

Formularies contain a list of medications covered by the plan:

Medication Exception
If your patient's medication is not listed, you can ask us to make a medication exception to our coverage rules if they are a member of one of our plans that offer prescription drug coverage.
Medication Exception Form

Network pharmacies

Network pharmacies consist of pharmacies we have made arrangements with to provide prescription drugs to plan members:

Prior authorization

Select medications may require prior authorization. A Physician, Pharmacy, or Member may request an authorization for a medication through the Samaritan Health Plan Operations Pharmacy Department. Prior Authorization Form