Pharmacy Provider Resources in Kentucky

This page provides centralized access to: 

• Quick access to training, resources and provider registration
• Pharmacy benefits overview 
• Preferred Drug List (PDL)/ Formulary lists and formulary tools
• Prior authorization (PA) processes 
• Clinical criteria and step therapy requirements 
• Physician-administered drug guidance 
• Drug recalls and safety notices 
• Policies

Getting Started

Availity Provider Portal Access

The Availity provider portal gives you quick access to essential tools, including member eligibility verification, medical prior authorization (PA) submission, authorization status checks, claims support and up‑to‑date policies and clinical criteria.

Pharmacy tools

Login in Availity provider portal

Register as a new provider

Pharmacy Benefits Overview

Medicaid

The Medicaid pharmacy benefit is managed by MedImpact. Contact MedImpact for pharmacy coverage questions, formulary assistance or claims support.

MedImpact: (800) 210‑7628

Medicare

The Medicare pharmacy benefit is administered through CVS Caremark. Contact MedImpact for pharmacy coverage questions, formulary assistance or claims support. You can view a list of in-network pharmacies via our Find a Pharmacy tool.

For additional information, please refer to the Medicare Part D section of the Provider Manual.

Passport Pharmacy Phone: (800) 665-3086

Part D Fax: (866) 290-1309

J Code Fax: (800) 391-6437

Drug formulary

2027 Passport Advantage (HMO D-SNP) H1799-003-001

2027 Passport Advantage (HMO D-SNP) H1799-003-002

2027 Passport Advantage (HMO D-SNP) H1799-003-003

2026 Passport Advantage (HMO D-SNP)

Step Therapy Grid

Medicare Part B Drug (J-Code) Step Therapy Medicare: Medical Part B Step Therapy Criteria 

Prior authorization list

Prior authorization form (Request For Medicare Prescription Drug Coverage Determination) 

Marketplace

Individual and Family plan (Marketplace) pharmacy benefits are managed by CVS Caremark. Contact CVS Caremark for pharmacy coverage questions, formulary assistance or claims support.

CVS Caremark provider call center: (800) 578-0775

Review our pharmacy policy page for information on prior authorization requirements, step therapy and more.