Pharmacy - Care Compass - Connecticut Office of the State 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information in the designated fields, including your name and address. Ensure accuracy for effective communication.
3. Review the list of drugs provided in the document. For each drug, check if it is on the formulary or subject to limits as indicated.
4. If a drug is not covered, follow the instructions to request a coverage determination or an exception. Fill out any required fields detailing your medical necessity.
5. Submit your request via phone, fax, or mail as outlined in the document. Make sure to keep a copy for your records.

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