The Physicians Plus Pharmacy Program is managed by the University of Wisconsin Hospital and Clinics Pharmacy Department, a nationally recognized leader in the development and implementation of drug use policy in health care settings.

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Member Pharmacy Information

Policies & more
About the Program

The Physicians Plus Pharmacy Program is based on local medical practice patterns and managed following NCQA best practices, this program helps provide effective medication management for patients.

Patient Medication Costs

You can determine the copay level (tier) for your patient’s medications by reviewing Physicians Plus Drug Formulary. The formulary lists medications alphabetically.

Certain medications require prior authorization before coverage is provided.


Important note: This pharmacy information is not applicable to members covered under the State of Wisconsin health insurance program or the BadgerCare Plus program.
State of Wisconsin members should contact Navitus Solutions and BadgerCare Plus members should call the State Medicaid Program.

Oral Oncology Program

Medications included in this specialty pharmacy program have been identified as requiring additional monitoring to provide the best patient outcomes and reduce waste. Prescriptions for these medications must be filled at a participating Physicians Plus Specialty Network pharmacy and a pharmacist trained in cancer therapies will assist a member through their treatment course.

During the first three months of treatment members will only receive two weeks of medication at a time. Members will pay half of their normal monthly copayment for each fill.

Please refer to the Summary of Benefits to see your specific cost share information. These medications are denoted as PF (Partial Fill) on the formulary listing.

Physicians Plus Specialty Pharmaceuticals Program


Please note: The Specialty Pharmaceuticals Program does not apply to medications administered in the physician's office, a hospital or other health care facility.
Formularies, Medication PA & PA List

To determine the copay tier level for medications, to search for drug information, or to view the status of medication prior authorization requests, please login to MyChart.

 

Extended International Travel Medication Supply

Physicians Plus Formularies

Find Your Formulary
PharmForms

Medication Prior Authorization

Forms & PA Criteria
Forms

Physicians Plus Medical Benefit Drug PA List

List is updated regularly

This health plan is underwritten by Physicians Plus Insurance, Inc.