Pharmacy

PrimeWest Health contracts with Prime Therapeutics, LLC. (Prime), to manage and pay pharmacy claims. Prime is a third-party administrator (TPA). Learn more about Prime.

Pharmacy Utilization Management programs
To see our Pharmacy Utilization Management program requirements for prior authorization, quantity limits, and step therapy, click on either of the links below.

Utilization Management programs for members of the following programs: Prepaid Medical Assistance Program (PMAP), Minnesota Senior Care Plus (MSC+), and Special Needs BasicCare (SNBC)

Utilization Management programs for members of the following programs: PrimeWest Senior Health Complete (HMO SNP) and Prime Health Complete (HMO SNP)

Learn more about the formulary exception process and documentation.