Care Management Programs

Scripps Health Plan’s Care Management Programs are designed to provide coordination of care for members identified with having long term and complicated health care needs.


These programs are focused on identifying member health needs and providing medically appropriate care in a coordinated and cost-effective manner. The Care Management nurse will work collaboratively with the member, their family and the interdisciplinary care team to support the plan of care. If you would like to refer a member to Care Management, please contact Scripps Health Plan customer service at 844-337-3700.


Our Care Management Programs are designed to complement the care delivered by doctors and other health care providers, and not to replace the treatment or advice of health care providers. The programs are voluntary and are provided at no additional cost to the member.


Pharmacy Management

Scripps Health Plan provides coverage for all medically necessary outpatient prescription drugs. Scripps Health Plan utilizes a formulary to define preferred drugs and requires prior authorization for all non-preferred drugs. Prescription drugs may only be prescribed by licensed physicians, licensed physician assistants, licensed nurse practitioners, dentists and licensed behavioral health practitioners in accordance with their credentials and licensure. Prescriptions should be written to allow generic substitution whenever possible and signatures on prescriptions should be legible, and electronically submitted when possible.


The Scripps Health Plan Prescription Drug Plan is managed by MedImpact, a trusted Pharmacy Benefits Manager (PBM). For inquiries related to your patient’s pharmacy benefit or prior authorization requirements, please call MedImpact customer contact center at 844-282-5343

MedImpact is available 24 hours a day, 7 days a week.


To locate a participating pharmacy, search the MedImpact Pharmacy Locator


Mailing address

MedImpact

10181 Scripps Gateway Ct.

San Diego, CA 92131

844-282-5343

TTY: 711


90-days’ supply of medications may be filled by MedImpact Choice90 network pharmacies, Scripps Outpatient Pharmacies or MedImpact Direct. Information about the mail order program is available at MedImpact Direct and in the MedImpact Direct order form


Specialty pharmacy

Specialty mediations are used to treat chronic and complex conditions and usually require particular medications for that condition. Specialty medications are more complex and are often used to treat conditions such as cancer, hepatitis C, hemophilia, multiple sclerosis, HIV and rheumatoid arthritis.


Scripps Health Plan members may receive specialty medications through Scripps Outpatient Pharmacy or through MedImpact Direct Specialty.


For specialty medication services through Scripps Outpatient Pharmacy, contact:


Scripps Green Outpatient Pharmacy

Phone: 858-964-1101

Fax: 858-554-2544


For specialty medication services through MedImpact Direct Specialty, contact:


MedImpact Direct Specialty 

8150 S. Kyrene Road, First Floor

Phoenix, AZ 85284

Phone number: 877-391-1103

Fax number: 888-807-5716

Email: specialtyhub@medimpactdirect.com