Essence Healthcare Home

• Intro to Essence Washington
• 2008 Essence Medicare Advantage Plan
• 2008 Essence Part D Medicare Drug Plan
• 2008 Drug Formulary
• Pharmacy Services
• Mail Order Pharmacy
• 2008 Paying for Drugs
• Drug Transition Policy
• Explanation of Benefits
• Filling Prescriptions Out-of-Network
• Quality Assurance & Utilization Management
• Appeals & Grievances, Exceptions & Coverage Determinations
• Medical Care and Providers
• Information for Members

Essence Washington Part D Medicare Prescription Drug Plan

Pharmacy Request Forms

Aranesp Request Form

Botox or Myobloc Request Form

Enbrel Self Injectable Biological Request Form -
(for Treating Arthritis)

Forteo or Boniva Coverage Determination Form

HIV RNA Tracking Form While Receiving Fuzeon

Fuzeon Medication History Form

Fuzeon Procedure and Required Information Form

Patient Self-Administered Growth Hormone Request Form

Home Infusion Therapies Request Form

Humira Self Injectable Biological Request Form -
(for Treating Arthritis)

Patient Self-Administered Injectable and
Specialty Drugs Request Form

Kineret Self Injectable Biological Request Form -
(for Treating Arthritis)

Leukine Request Form

Neupogen Request Form

Self Injectable Non Pegylated Interferons Request Form -
(for Hepatitis C treatment)

Self Injectable Pegasys Interferons Request Form -
(for Hepatitis C treatment)

Self Injectable Peg-Intron Interferons Request Form -
(for Hepatitis C treatment)

Procrit Request Form

Self Injectable Ribavirin Interferons Request Form -
(for Hepatitis C treatment)

Risperdal-Consta Request Form

Serostim Request Form

Xolair Request Form

• Enrolling In Essence
• Request More Information
• Member Customer Service
• Attend a Community Informational Meeting

Essence is a Health Plan with a Medicare Contract.
Copyright © 2008 Essence Healthcare. All rights reserved.