At Solis, our goal is to make a difference through personal service. As a valued Solis Health Plans provider, we aim to have all the pharmacy information you need in one place. Below you will find important documents and forms relating to Part D coverage:

• You can access our 2024 formulary of covered prescription drugs here.
• For 2023 covered prescription drugs, please click here.

Prescription Drug Transition Policy

When entering a new plan, getting used to all of the changes can be confusing for members. At Solis, we want to make the transition for our members easy. If you are unable to get your prescription medications due to it not being covered or because it requires a prior authorization, we have the tools to help. Please access our transition policy for more information:

• Part D Formulary Transition Policy (2023)
• Part D Formulary Transition Policy (2024)

Coverage Determination Request Form/ Exception Request

To request a drug coverage determination, the member, an appointed representative, or you, as the prescribing physician can contact Solis in one of the following ways:

• The member can ask their prescribing physician or other prescriber to submit the request for you. You may call our Pharmacy Coverage Determination Review team at 1-833-615-9259 and request a coverage determination request over the phone. We are available to take your prescriber’s call Monday to Friday, 8 a.m. to 5p.m.
• Alternatively, the prescribing physician or other prescriber can submit a coverage determination request form for the member. The prescriber may call the Pharmacy Coverage Determination Review team at the number provided above and request a coverage determination form specifically designed for the drug that is being requested and submit the completed form to us by fax at 1-855-668-8552. This form will include specific questions to ensure all required information is obtained for the review. The physician can also submit the request for you online by filling out the Coverage Determination Request Form, which is a general form. This form may require the Pharmacy Coverage Determination Review team to contact your prescriber to obtain additional information specific to the drug being requested.

Download the Coverage Determination Request Form (Prescription Coverage) here.

Note: You can also access the Drug Determination Request Form at the CMS part D webpage link here.

Request for Redetermination (Appeal) of Medicare Prescription Drug Denial

For the Request for Redetermination (Appeal) of Medicare Prescription Drug Denial Form click  here