State Agency Directory
|
Online Services
Menu
Members
Providers
Retirees with Medicare
Benefit Coordinators
Financial Reports
Miscellaneous
Prescription Drug Benefits
High Performance Preventative Drug List (Plan C)
High-Performance Preferred Drug List
Our Customers
Members
Providers
Retirees with Medicare
Benefit Coordinators
Our Services
PPB Plans
The Health Plan
Humana
Life Insurance
Mountaineer Flexible Benefits
Health Information
Health & Wellness Programs
Health Tips
Web Sites
Forms & Downloads
Members
Providers
Retirees with Medicare
Benefit Coordinators
Financial Reports
Miscellaneous
Prescription Drug Benefits
News Center
News Releases
Benefit Coordinator Briefing
Publications
Announcements
Contact Us
PEIA Staff
Express Scripts
Subrogation & Recovery
About PEIA
Finance Board
Financial Reports
Manage My Benefits
| Font size
A
A
A
|
Print this Page
PEIA
>
Forms & Downloads
>
Prescription Drug Benefits
Prescription Drug Benefits
The prescription drug benefits below only apply to the Preferred Provider (PPB) Plans:
High-Performance Preferred Drug List (Plans A, B and C)
High-Performance Preventative Drug List (Plan C)
Retail Maintenance Network
Maintenance Medications List
Common Specialty Medications
Case Managed Drugs
Prior Authorizations/Drugs with Special Limitations
Prescription Drug Claim Form
Prescription Drug Claim Form (foreign)
About PEIA
|
Our Customers
|
Our Services
|
Health Information
|
Forms and Downloads
Finance Board
|
Financial Reports
|
News Center
|
Links
|
Contact Us
|
Site Map
Privacy, Security and Accessibility
|
WV.gov
|
USA.gov
| © 2012 State of West Virginia