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Pharmacy

90-Day Maintenance Drugs

Effective October 16, 2019, Nebraska Total Care members will be able to get up to a 90-day prescription fill on maintenance medications. Maintenance medications are used to treat chronic, long-term conditions or illnesses. Nebraska Total Care has a list of 90-Day Maintenance Drugs (Excel).

Pharmacy claims processing change

Effective April 1, 2019, Envolve™ Pharmacy Solutions will transition Nebraska Total Care claims processing to RxAdvance. The Pharmacy Claims Update document (PDF) was distributed to pharmacy providers and includes all of the information necessary for processing claims after that date.

Pharmacy Prior Authorization Fax Number Change

Please update your fax system and your Prior Authorization systems to reflect the change in fax number to 1-877-386-4695 for requests from April 1st, 2019 forward. The contact information update document can be found on the Prior Authorization Fax Number Change update (PDF).

Nebraska Total Care is committed to providing appropriate, high-quality, and cost-effective drug therapy to all Nebraska Total Care members. Nebraska Total Care covers prescription medications and certain over-the-counter medications with a written order from a Nebraska Total Care provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services may be covered as well.

Contact Us

RxAdvance Help Desk
Phone: 1-800-974-5268

Envolve™ Pharmacy Solutions
Prior Auth Phone: 1-844-330-7852
Prior Auth Fax: 1-877-386-4695

Nebraska Total Care
Phone: 1-844-385-2192, Nebraska Relay Service 711