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Members

Welcome Care1st Medicare Members

Care1st Medicare 2018 Main Website

Explore this page to learn more about your Plan and Benefits as well as our services and programs.

Pharmacy Services

Drug Formulary Search
Medicare Drug Formulary Search & Co-Pays

Drug Formulary List
Download the 2018 Drug Formulary

Notice of Formulary Changes
These correction notices are updates to the 2016 Drug Formulary List in PDF Format. The Formulary Search is updated with these notices each month.

Pharmacies
Search for Pharmacies Near You


Walgreens Pharmacy
Refill a Mail Order Prescription

If you have an existing mail order drug prescription with remaining refills, you may request a refill from Walgreens.


Drug Information

Potential Drug-Drug Interactions
Common Side Effects & Potential Risks
Availability of Generic Substitutes

Coverage Determination & Prior Authorization for Prescription Drugs

Here are the instructions and an online request form for you to find out if your prescription drugs are covered under your plan and instructions for submitting a request for a prior authorization.

Instructions for a Coverage Determination
Online Request for a Coverage Determination
Instructions for a Prior Authorization
Quality Improvement
Quality Improvement
Care1st wants to make sure you get good care and services.
Member Services

ID Card
Request your Care1st Member ID Card


PCP Change
Request to Change your Primary Care Physician (PCP)


Treatment Authorization or Referral

Here are instructions on how to request a treatment that requires prior authorization.
Also included are instructions on obtaining a referral from your Primary Care Physician in order to visit a Specialist.

Coverage Determination for Treatment
Prior Authorization for Treatment
Referral for Treatment
Materials & Resources

Member Materials & Publications
Preventive health guidelines, brochures, member newsletters and other materials to keep you informed...

Provider and Pharmacy Directory
Request a copy of your Care1st Directory

Provider and Pharmacy Directory
On-line Search

Member Resources
General Information, Prior Authorizations (Organization and Coverage Determinations) / Exceptions, Appeals & Grievances Process, Forms and more...

Report Provider Information Inaccuracies

If you believe there is a potential inaccuracy or error in our directory, please let us know using one of the following ways:

By Telephone
1-800-544-0088
TTY/TTD: 711
Hours: 8:00 a.m. – 8:00 p.m., seven days a week
Electronically through our website:
In Writing
Care1st Health Plan
Member Services Department
601 Potrero Grande Dr.
Monterey Park, CA 91755
Health and Wellness
Health & Wellness web site member login
Log on to the Health & Wellness member web site to take charge of your health. You'll find many tools to help you eat healthier and be more active.
Health Education
Important information on topics like staying fit, managing diseases, healthy eating and maintaining a healthy weight.
Financial Responsibility
Claims Information
Cost of Treatment

If you have any questions about the cost for care you received from your doctor or hospital; or if you receive a bill for a service, please call Care1st Member Services at:

1-800-544-0088
Hours: 8 a.m. to 8 p.m., seven days a week.
TTY: 711
Hours: same as above.

If you have any questions about the cost of a treatment or service for a specific provider or institution, please call Care1st Member Services at:

1-800-544-0088
Hours: 8 a.m. to 8 p.m., seven days a week from October 1 through February 14 (except Thanksgiving and Christmas), and 8 a.m. to 8 p.m., Monday through Friday from February 15 through September 30 (except holidays).
TTY: 711
Hours: same as above.

Care1st Health Plan is exempt from providing information on the cost of a treatment or service for a specific provider or institution on the Care1st Health Plan member web site for NCQA requirements. Care1st Health Plan has a fully delegated model with over 50 different Medical Groups. The Medical groups are capitated for all professional services. Capitation is a payment arrangement for health care service providers such as physicians or nurse practitioners. It pays a physician or group of physicians a set amount for each enrolled person assigned to them, per period of time.

Close

Contact Us

If you have any questions about your benefits, please call Care1st Member Services at:

Telephone
1-800-544-0088
Hours: 8 a.m. to 8 p.m., seven days a week.
TTY: 711
Hours: same as above.
FAX: 1-323-889-2100
Mailing Address:
Care1st Health Plan
Member Services Department
601 Potrero Grande Dr.
Monterey Park, CA 91755
Email
to send us an email.

Material ID: H5928_17_011_WEB CMS Pending Approval