Upper Peninsula Health Plan
UP Health Plan

PHARMACY INFORMATION

UPHP Restricted Drug Classes List - Updated 11/2005

Oral Contraceptive Coverage - Updated 11/2005

4D Request for Prior Authorization - Effective 6/10/2005

4D Ascensia® Glucose Meter Fax Order Form - Effective 1/1/2006

4D Ascensia® Glucose Meter Characteristics Chart - Updated 1-1-2006

Policies
  • Pharmacy Management
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  • Pharmacy Prior Authorization Process
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  • Pharmaceutical Safety
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    Providers/Prescribers

    For information about UPHP pharmacy services not specified on the above forms, call 4D Pharmacy Management Systems at 1-888-274-2031.

    Pharmacists Claims System

    For inquiries and support please call 1-888-378-4743.

    UPHP Members

    For information about UPHP pharmacy services, call UPHP Customer Service at 1-800-835-2556.

    Please contact our Webmaster with questions or comments
    © Copyright 1999 Upper Peninsula Health Plan, Inc. All rights reserved.

    Upper Peninsula Health Plan - 228 W. Washington Street - Marquette, MI 49855

    1-800-835-2556 or  906-225-7500

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