Medicare Advantage

Part D Prescription Drugs

The CHRISTUS Health Plan Generations Medicare Plan includes coverage of Medicare Part D prescription drugs, as well as those covered under Medicare Part B. The following chart depicts the pharmacy related services provided by CHRISTUS Health Plan Generations, the entity responsible for providing or addressing questions regarding the service, as well as the contact information.

Pharmacy Related Service

Part D Prescription Drugs (ESI)
Pharmacy Department: 1-844-470-1531
Pharmacy Help Desk: 1-800-922-1557
Pharmacy Fax Number: 1-877-329-3760

Coverage Determination (ESI)
Standard/Expedited Coverage Review: 1-800-935-6103

Formulary Exceptions (ESI)
Coverage Review: 1-800-935-6103
ePA Coverage Review: Learn More

Medication Therapy Program (ESI)
Pharmacy Department: 1-844-470-1531
Pharmacy Help Desk: 1-800-922-1557
Fax Number: 1-877-329-3760

Covered Vaccines Under Part B (CHRISTUS)
Member Services: 1-844-282-3026

Covered Vaccines Under Part D (ESI)
Fax claim form to: 1-608-741-5483

Express Scripts:
Attn: Med D Claims
P.O. Box 2858
Clinton, IA 52733-2858

Pharmacy claims are processed by Express Scripts (ESI), the CHRISTUS Health Plan Generations pharmacy benefit management vendor. Medicare Part D prescription drugs are only available by prescription, are used or sold in the United States and must be used for medically accepted indications. Part D covered prescription drugs are listed in the CHRISTUS Health Plan Generations Medicare formulary. The formulary includes all generic drugs covered under the Part D program, as well as many brand-name drugs, non-preferred brands and specialty drugs.

The Medicare Part D formularies are reviewed by a Pharmacy and Therapeutics Committee composed of physicians and pharmacists who have been approved by the Centers for Medicare & Medicaid Services (CMS). Providers can view a copy of the CHRISTUS Health Plan Generations formulary.