Pharmacist discussing prescriptions with a woman holding her toddler

Prescription Coverage that Works for You

We want to make sure you have access to the medicine you need to get healthy and stay healthy. 

Community Health Plan of Washington partners with Express Scripts to give you access to a large network of pharmacies and a wide range of covered prescriptions. 

Go to Express Scripts to log in or create an account. An account will help you manage your prescriptions, search for pharmacies, and learn more about your medicine.

What We Cover

The drugs we cover are listed in our formulary. The drugs are chosen by a Pharmacy and Therapeutics Committee, which is made up of local providers and pharmacists. Community Health Plan of Washington and the Washington State Health Care Authority decide which drugs to cover based on medical studies and research and the needs of members. All of the drugs in our formulary are FDA approved. You will need Adobe Acrobat to read the PDFs. Download it for free.

2020 Prescription Coverage

Search our 2020 formulary

Download 2020 formulary as PDF

To request a hard copy of the formulary be sent to you in the mail free of charge, please call Customer Service at 1-800-440-1561 (TTY Relay: Dial 711), from 8 a.m. to 5 p.m., Monday through Friday.

Get a Larger Supply of Select Medications

CHPW covers 90-day supplies for most chronic medications. Ask your physician or pharmacist for a 90 day supply of your medications at your next visit.

Special update during COVID-19:
Restrictions around filling a prescription too soon have been lifted for many medications.

Our members can get a 90-day supply of select medications used to treat chronic conditions (known as maintenance medications) such as high blood pressure, diabetes, and depression.

Larger supplies of prescriptions are available exclusively through Community Health Center pharmacies and select network pharmacies (preferred pharmacies). Ask your provider if any of the medications you are taking are eligible for a 90-day fill.

You may also be eligible for free home delivery of your long-term medications.

Prescriptions Mailed to Your Home

Call, mail or have your prescriber send in your prescriptions to a Walmart pharmacy and start getting your medicine sent right to your house. 

Get started

  • Call: 1-800-273-3455. Walmart will set up your profile over the phone and get your prescriptions into their system.
  • Mail: Fill out the Prescription Order Form. Mail your original written prescriptions and the Order Form to the address on the form.
  • Talk to your prescriber: Ask them to call in your prescription or fax in the Prescription Order Form.

Refill your prescriptions

You can contact Walmart's Home Delivery service four ways to request a refill. 

  • Call 1-800-273-3455 and follow the automated prompts.
  • Email wmsrx@wal-mart.com.
  • Mail your name, RX number, and phone number to: Walmart Home Delivery, 1025 W. Trinity Mills Rd, Carrollton, TX 75006.
  • Fax your name, RX number and phone number to: 1-800-406-8976.

Download the Walmart App to manage your prescriptions, refills, and deliveries from your phone.

Read more about the program: www.walmart.com/homedelivery

Special update during COVID-19:
Rite Aid:

Rite Aid is offering free delivery for our Apple Health members during this outbreak. To learn what your mailing options are, contact the pharmacy where you get your prescriptions filled.

Walgreens Express:

Walgreens is offering home delivery of prescriptions as a temporary service to our members.

To get your prescriptions delivered through Walgreens, you must sign up with Walgreens Express. Text JoinRx to 21525. (For Spanish, text UneteRx.) When your prescription is ready, you will receive a text alert with a Walgreens Express link. Follow the link, choose delivery as your option, and confirm your address.

Read more about the program: https://www.walgreens.com/topic/pharmacy/walgreens-express.jsp

Walmart's Home Delivery Service:

  • Call 1-800-273-3455 and follow the automated prompts.
  • Email wmsrx@wal-mart.com.
  • Mail your name, RX number, and phone number to: Walmart Home Delivery, 1025 W. Trinity Mills Rd, Carrollton, TX 75006.
  • Fax your name, RX number and phone number to: 1-800-406-8976.

Download the Walmart App to manage your prescriptions, refills, and deliveries from your phone.

Read more about the program: www.walmart.com/homedelivery

Mail order from select CHCs:

If you have been assigned to Healthpoint or Yakima Valley Farm Workers Clinic and get your care there, you can request home delivery of your prescriptions.

Personal Medication Coach Program

The Personal Medication Coach Program helps member who are managing more than one medical issue and are taking multiple medications. We partner with SinfoniaRx to work with you and your doctors and make sure your medications are working to improve your health.

You can learn more about this program by visiting sinfoniarx.com or calling 1-844-866-3730.

Prior Authorization

Some drugs require prior authorization, which means Community Health Plan of Washington has to review and approve coverage before we can help you pay for them. You can check whether your medicine needs prior authorization or has any coverage restrictions by calling Customer Service or checking our formulary.

You can submit a request for a coverage determination review by sending in a Coverage Determination Request form or filling out the online form

Non-Covered Prescriptions

If you need medicine that isn’t listed on our formulary, you can request a coverage determination review through Customer Service.

If your coverage is denied by Express Scripts, you can appeal the decision with Community Health Plan of Washington. Read about how to appeal or file a grievance.

If you paid full price for a prescription at a retail pharmacy, you can ask for a reimbursement. Check the formulary to make sure there were no restrictions on your medication before you ask to be reimbursed. Fill out a reimbursement form and either fax or mail it to Express Scripts. 

Find a Pharmacy

We have an extensive network of pharmacies across Washington, Oregon, Idaho, and Montana. Many of our Community Health Centers have their own pharmacies. To find the pharmacy closest to you, you can:

Be sure to bring your Community Health Plan of Washington ID card when you pick up your prescription. If you don’t have your card, you can log in to your myCHPW account to view, download, and print a copy of it.

Some complex or chronic illnesses need specialty drugs that require a higher level of service or care. Our specialty drugs are covered when they are dispensed through Accredo Specialty Pharmacy or participating Community Health Center pharmacies. Check our formulary for your specialty drug and ask your local Community Health Center if their pharmacy supplies your medication.

Find your local Community Health Center.

If you’re traveling outside of our coverage area, please contact us. Usually, prescriptions filled outside of our network aren’t covered. Pharmacies can dispense up to a 72-hour supply of a medication in an emergency.

Staying Safe

We follow 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 our pharmacy coverage policies or benefits, you can:

  1. Check your coverage in your member benefit handbook
  2. Contact Community Health Plan of Washington Customer Service by phone at 1-800-440-1561 (TTY Relay: Dial 711), from 8 a.m. to 5 p.m., Monday through Friday, or by email at customercare@chpw.org

Keep track of medication: Download a medication list. Write down your medication, supplements, and over the counter products. Bring the list with you to all your appointments.

Recalled medication: Sometimes prescriptions are recalled. If your prescription is recalled, do not continue to take it and contact the provider who prescribed it to you right away. Check the latest drug recalls.

Help stop fraud: We participate in pharmacy fraud and abuse monitoring. If you suspect misuse or overuse of pharmaceuticals, call Customer Service.

Understand your prescriptions: Express Scripts offers safety information about your prescriptions, including possible side effects and harmful drug interactions. Log in to Express Scripts or create an account