Part D Coverage

Prescription drug coverage information for Champion Health Plan members.

Plan Year

State

Language

Plan Name

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Step Therapy

Learn more about Step Therapy.

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Formulary Look Up Tool

Use as a look up tool to search for covered medications You can also check your drug(s) to see the cost of your prescriptions and the closest pharmacy where you can pick them up through our RealTime Benefit Tool.

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Submit a Part D Prescription Drug Claim or Bill

To submit a Healthcare Claim or Bill, please complete the form and submit the form and receipt(s) to: MedImpact Healthcare Systems, Inc. PO Box 509108 San Diego, CA 92150-9108 Fax: 858-549-1569 E-mail: Claims@Medimpact.com

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MedImpact Direct Mail Order Prescription Drug Forms (English)

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