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Under certain circumstances, the plan can offer a temporary supply of a drug to you when your drug is not on the Drug List or when it is restricted in some way. Doing this gives you time to talk with your doctor about the change in coverage and figure out what to do.
To be eligible for a temporary supply, you must meet the two requirements below:
Our plan will cover a temporary 31-day supply of non-formulary drugs (unless the prescription is written for fewer days) for current members with level of care changes.
To ask for a temporary supply, call Member Services Toll-Free at (866) 704-0109.
During the time when you are getting a temporary supply of a drug, you should talk with your doctor to decide what to do when your temporary supply runs out. Perhaps there is a different drug covered by the plan that might work just as well for you. Or you and your doctor can ask the plan to make an exception for you and cover the drug in the way you would like it to be covered. The sections below tell you more about these options.
If you need medical attention or need to fill prescriptions after your coverage begins, but have not received your ID card, please have your medical provider or pharmacist call Vantage at 1-318-361-0900, Toll-Free 1-888-823-1910 or TTY at 1-866-524-5144 (for the hearing impaired).
Vantage Health Plan conducts drug use reviews for our members to help make sure they are getting safe and appropriate care. These reviews are especially important for members who have more than one provider who prescribes their drugs.
We do a review each time you fill a prescription. We also review our records on a regular basis. During these reviews we look for potential problems such as:
If we see a possible problem in your use of medications, we will work with your doctor to correct the problem.
Vantage Health Plan has programs that can help our members with special situations. For example, some members have several complex medical conditions, they may need to take many drugs at the same time, or they could have very high drug costs.
These programs are voluntary and free to members and are not considered a benefit. A team of pharmacists and doctors developed the program for us. The programs can help make sure that our members are using the drugs that work best to treat their medical conditions and help us identify possible medication errors.
If we have a program that fits your needs, we will automatically enroll you in the program and send you information. If you decide not to participate, please notify us and we will withdraw your participation in the program.
This page was last updated:4/13/2017
Vantage Health Plan, Inc. is an HMO plan with a Medicare contract. Enrollment in Vantage Health Plan, Inc. depends on contract renewal.
H5576_4006_03_CY17_CMS Approved 4/17/2017