As a member of CHRISTUS Health Plan Generations, you have prescription drug coverage for Medicare Part D in addition to medical and hospital benefits.
To see if CHRISTUS Health Plan covers a prescription drug, please call member services at 1-844-470-1531. To keep costs low for members and reduce medication errors, we use utilization management practices and drug utilization reviews. Read more about these practices below.
Utilization management is a practice where some medical services and drugs are evaluated for need before they can be used. This means that for certain prescription drugs, special rules restrict how and when the plan covers them. A team of doctors and pharmacists developed these rules to help members use drugs effectively and keep coverage affordable. Examples of utilization management include:
You can find out if your drug is subject to these additional requirements or limits by looking in our formulary. If your drug does have additional restrictions or limits, you can ask us to make an exception to our coverage rules.
These reviews are especially important if you have multiple doctors who prescribe medications. We conduct reviews each time you fill a prescription and on a regular basis. If we see a problem during our review, we will work with your doctor to correct it.
H1189_MM143 pending approval
Last Updated: 2/23/17