Pharmacy Benefits
Community Health Plan offers members online pharmacy support via the Express Scripts (ESI) web site. For help finding what drugs are covered, determining copayments, searching for a participating pharmacy, or general drug and health information, just click the appropriate link below:
Community Health Plan members use the ESI Access Your Account tool. If you are a first-time user, please use the ESI Activate Your Account tool.
Prescription medication can be a critical part of your health care. That’s why Community Health Plan makes it easy for you to get your prescriptions filled. We have more than 1,000 participating pharmacies throughout Washington State, including many pharmacy chains and neighborhood pharmacies.
To get a current list of pharmacies in the Healthy Options, SCHIP, Basic Health, or GA-U network:
- Contact the Community Health Plan customer service team at 1-800-440-1561 (toll free). If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.
- Search for a participating pharmacy. Community Health Plan members use the ESI Access Your Account tool. If you are a first-time user, please use the ESI Activate Your Account tool.
Community Health Plan follows federal laws that set standards to guarantee safe and
effective pharmacy services. You have the right to know what pharmacy services
are covered by your plan. If you would like more information or a copy of
Community Health Plan pharmacy coverage policies or benefits, please call Customer Service
at
Community Health Plan monitors the safe use of pharmaceuticals through a fraud and abuse program and reserves the right to limit a member’s provider and pharmacy selection if over-utilization or misuse has been identified.
Things to remember
- To receive Community Health Plan prescription benefits, you must show your Community Health Plan ID card and have your prescriptions filled at one of the pharmacies listed.
- Certain drugs require prior authorization from Community Health Plan before they are covered.
- As new products become available or new indications are given for specific circumstances or protocols,Community Health Plan reserves the right to make additions or deletions to the list of drugs requiring prior authorization.
- Maximum quantity limits are required on some drugs to ensure safe utilization.
- Use of half tablets is recommended on certain drugs. The pharmacy will give you a tablet splitter with no co-pay required from you when you present a prescription for a drug taken in half tablets.
For information on patient safety and managing your medications, click on
the links below.
Patient Safety
www.talkaboutrx.org
www.bemedwise.org
Important! The Formulary Search is not applicable for Medicare Advantage Plan Members. Please go to www.healthfirst.chpw.org for the Medicare Advantage Plan formulary.
