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Resources

Members

Formulary and Drug Lists
Please visit your member portal for the formulary and drug lists for your pharmacy benefit plan.
Home Delivery Information
Home Delivery Flyer
Costco Patient Profile Form
Visit Costco Pharmacy
Pharmacy Directory
Pharmacy Directory
Reimbursement Claim Forms
Member Reimbursement Form
Compound Claim Reimbursement Form
Other Forms
Release of Information Form

Prescribers

Prior Authorization Form
Exception to Coverage Request

Pharmacies

Payer Sheet
Pharmacy Network Credentialing Form
Pharmacy Manual
MAC Appeal Form