2023 YAMHILL COMMUNITY CARE

Welcome Yamhill Community Care has a list of covered drugs called a Formulary.

If you want a copy of this formulary, need this formulary in another language, large print, Braille, or other format, please call the Customer Service number of your CCO listed below. TTY users can call 711. You can always view the most recent version of this drug list on your CCO’s website.

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COVID-19 Vaccination

Vaccination is a safe, effective, and reliable way to prevent getting sick from COVID-19. Getting vaccinated is one of the best ways to protect you and your family.

COVID-19 vaccines are available at no cost
All FDA-authorized and FDA-approved COVID-19 vaccines are provided at no charge to you, no matter where you get the vaccine. This includes when multiple doses are required and recommended boosters.

Everyone 6 months of age and older is eligible to get a COVID-19 vaccine

The most current vaccine information, including recommendations for boosters and special populations, can be found on the CDC website.

For the most update to information on COVID-19 Vaccine, please visit our Frequently Asked Questions (FAQ) page.

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Influenza

Influenza — also known as the flu — is a highly contagious respiratory virus. The effects of the flu vary from person to person and range from mild to severe. The best protection against the flu is to get a flu shot each year.

Did you know that you may be able to get a flu shot at an in-network pharmacy?

Flu vaccines are available at many retail pharmacy locations or through your in-network health care provider.

Going to the pharmacy is a convenient option as generally no appointment is needed and flu shots are covered at no cost to our members with proof of insurance.

If you are 19 or older, you can get the flu shot at an in-network retail pharmacy. Children (ages infant through 18) need to go to a Vaccine for Children facility (VFC), or to your PCP.

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A formulary is a list of covered drugs which represents the prescription therapies believed to be a necessary part of a quality treatment program. We will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Evidence of Coverage.

Printable Files

The following files require Adobe Acrobat. Download Adobe Acrobat

• Printable Formulary
• Prior Authorization
• Step Therapy

HOW TO SEARCH FOR DRUGS

Use the alphabetical list to search by the first letter of your medication.

Search by typing part of the generic (chemical) and brand (trade) names.

WHAT IF MY DRUG IS NOT ON THE FORMULARY?

If your drug is not on the formulary, it means we do not cover it.

Your doctor can ask for an exception. Ask your doctor to mail or fax us a “prior authorization” or Medication Exception Request Form if they feel this is the best drug for you.

We will review your doctor’s request and either approve or deny the request.

WHAT IF I URGENTLY NEED A DRUG THAT IS NOT ON THE FORMULARY?

If this happens, please contact us right away. You, your doctor, or someone you appoint as your representative can contact us.

If we determine that your life or health are at risk, we will review the request within one day (24 hours).


You can call our Customer Service team at one of the following numbers between 8 a.m. and 5 p.m., Monday through Friday if you have questions about the formulary:

Customer Service: 1-877-216-3644

TTY/TDD users should call 711


Please see your Member Handbook or contact the Pharmacy Department at (877) 216-3644 for questions.
For members of Yamhill Community Care