The Quartz Pharmacy Program is based on local medical practice patterns and managed following NCQA best practices, this program helps provide effective medication management for patients.
The Prescription Drug Benefit Brochure provides detailed information about Quartz’s pharmacy benefits.
Patient Medication Costs
You can determine the copay level (tier) for your patient’s medications by reviewing Quartz’s Drug Formulary. The formulary lists medications by drug class according to the copay tier.
Quartz populates formulary information with the Surescripts hub for use in e-prescribing applications. Surescripts will display the copay tier of the medication.
Certain medications require prior authorization before coverage is provided.
Quartz’s Specialty Pharmaceuticals Program
Quartz’s Specialty Pharmaceutical Program provides high-quality clinical monitoring for patients using specialty medications while helping keep coverage of these products affordable.
Specialty medications are only covered with an approved Medication Prior Authorization and if obtained through a Pharmacy in Quartz's network.
The Quartz Drug Formulary includes the designation of “SP” if the medication is in the Specialty Pharmaceuticals program. Call UW Health Pharmacy at (866) 894-3784 or Gundersen Health System Pharmacies at (877) 208-1096 with questions or to help enroll a patient in the 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.
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.
Formularies, Medication PA & PA List
To determine the copay tier level for medications, or to learn the status of medication prior authorization requests, please call Quartz Customer Service at (800) 362-3310.