If you have questions about submitting COVID-19 vaccine claims, please reference
the NCPDP Emergency Preparedness Guidance for COVID-19 Vaccines.
Questions about the COVID-19 vaccine and how it affects plans and members? Learn more
The Serve You Rx team is commitment to service extends beyond our members, clients and partners, and includes providers as well. We’re here to provide you with the resources and tools you need to maximize the patient’s pharmacy benefit experience. If you have any questions, in-house Serve You Rx customer service representatives are available to help.
Monday-Friday, 7:30 am-9 pm CST | Saturday, 8 am-6 pm CST | Sunday, 9 am-3 pm CST
Preferred Drug List
The Serve You Rx Preferred Drug List (PDL) will help you and your medication prescriber choose safe and effective drug therapies that are cost effective and covered by your pharmacy benefit. Click the links below to view the most recent versions of the Serve You Rx PDL.
Preferred Drug List – Select
Preferred Drug List – Standard
Preferred Drug List Recent Changes – Select
Preferred Drug List Recent Changes – Standard
Serve You Rx Select Formulary Excluded Product List
Specialty Drug List
ACA Preventive Medication List
ACA Immunization Program
Step Therapy Program
All forms are in .pdf (Acrobat) format. You can download the latest version of the Acrobat Reader software on Adobe’s website for free.
To ensure proper delivery of care, you may be asked to complete and return specific forms to Serve You Rx. Below is a list of commonly used forms. To request additional forms (i.e., drug-specific forms), please call 800-759-3203:
BIN 610548 D.0 Payer Sheet
Serve You Rx Prior Authorization Information and Drug List
Standard Prior Authorization Form
Standard Prior Authorization Form (Louisiana Residents)
Step Therapy Exception Form
Quantity Limit Override Request Form
Opioid – Long Acting Prior Authorization Form
Opioid – Short Acting (Quantity Limits) Prior Authorization Form
Compound Prior Authorization Form
These forms are in .pdf (Acrobat) format. You can download the latest version of the Acrobat Reader software on Adobe’s website for free.
Join the Serve You Rx Network
To join the Serve You Rx network of more than 66,000 retail pharmacies nationwide, which includes independent pharmacies and national chains, please click the button below and submit the online request form. You may also request a network pharmacy application by emailing us at firstname.lastname@example.org