Check if your medication is covered, locate in-network pharmacies, and set-up home delivery. Also get details about 90-day supplies, specialty drug pharmacies, prior-authorization, and more for Apple Health (Medicaid) and Apple Health Expansion plans.
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Check covered medications
Prescription drugs lists | Non-prescription | Coverage pre-approval
Prescription drug lists
Check if your medication is covered in your plan’s prescription drug list (formulary). Search the list with our online tool or view an A-Z list.
Formularies or drug lists may change weekly.
Search online drug list
Search drug list
Search drug list
Do you have an Express Scripts account? You can search there too!
View A-Z drug list
Get a full list of all your covered prescription drugs (formulary). These lists can change weekly.
Need a printed drug list or formulary mailed to you? Contact Customer Service, and we’ll send it within 5 business days of your request.
Non-prescription coverage
Some birth control products, emergency contraceptive pills, and vaccines are available without a prescription or “over-the counter” (OTC).
Get them at no cost to you from in-network pharmacies. Be sure to bring your ProviderOne Card and CHPW member ID and talk to a pharmacist.
Birth control and emergency contraceptives
- Covered without limits on age, quantity, or frequency at no cost to you when billed by a pharmacy that accepts Apple Health.
- Includes condoms, Opill, and emergency contraceptive (the morning after pill).
View a list of covered OTC contraceptives ➔
How to get OTC birth control
- Find a pharmacy that accepts Apple Health
- When you go, bring your Provider One Card and CHPW Member ID card
- Go to the pharmacy counter so the pharmacy can bill Apple Health for the birth control
Apple Health does not pay you back (reimburse) for OTC birth control you purchase yourself.
If the pharmacy has questions on how to bill for OTC birth control, refer them to the provider’s CHPW Pharmacy page.
When a prescription is needed for birth control
Some birth control requires a visit to a doctor to get:
- Some birth control pills
- Patches or rings taken daily or weekly
- The Depo shot, Depot-medroxyprogesterone (DMPA, Depo-Provera)
- Intrauterine devices (IUD)
For more information on birth control talk with a health provider for guidance or visit the Department of Health birth control and emergency contraception page.
Immunizations and vaccinations
Covid-19: The Pfizer BioNTech, Moderna, and Novavax COVID-19 vaccines are covered at any location they are offered.
Drug coverage pre-approval (prior authorization)
Some medications, CHPW must approve coverage (give prior authorization) before we can help you pay for them.
To request prior authorization, fill out the Request for Prescription Coverage form online. Or print, complete, and send the Prior Authorization, General Request form by fax.
Request online Print and fax form
Find out if you need prior authorization by locating the drug in your plan’s drug formulary. Or call our Customer Service team.
Not sure if a drug is covered, or if you need prior authorization?
Call Customer Service at 1-800-440-1561 (TTY: 711), from 8 a.m. to 5 p.m., Monday through Friday.
Find a pharmacy: Pick-up and delivery
Search pharmacies | Pick-up | Delivery
Fill your prescriptions at in-network pharmacies to make sure the cost is covered. Apple Health (Medicaid) and Apple Health Expansion use the same Pharmacy Directory.
Search in-network pharmacies
Login or register at Express Scripts to search online. Or view an A-Z list in the CHPW Apple Health Pharmacy Directory.
Search at Express Scripts View list ➔
Pharmacies for specialty drugs
Some complex or chronic conditions require specialty drugs that regular CHPW pharmacies don’t offer.
When that happens, contact your Community Health Center Pharmacy or go through Accredo Specialty Pharmacy.
Pick-up: Filling prescriptions in-person
Your Community Health Center may have a pharmacy. Or your local grocery or drug store may be an in-network pharmacy.
Options are available in Washington, Oregon, Idaho, and online.
Delivery: Mail order online
Order prescriptions online and have them mailed to you. There are three options:
Option 1: Costco pharmacy
No Costco membership needed, and there’s no additional cost. Get started at pharmacy.costco.com.
How to set up Costco home delivery
Create your account online, by phone, through your doctor, or by mail.
- Online at pharmacy.costco.com. Click “Get Started” to create an account. Once logged in, click “Shop as Non-Member” and then “Complete Patient Profile”.
- Call Costco at 1-800-607-6861. They will create your account over the phone and ask you for your prescription information.
- Ask your doctor’s office or your prescriber, to contact Costco and give them your prescription information for home delivery.
- To mail, print and fill out the Prescription Order form. Mail your original written prescriptions and form to the address provided.
How to fill or refill your prescriptions at Costco
To fill a prescription, choose what works best for you:
- Go online to pharmacy.costco.com, register or login to fill and refill prescriptions, check status, or transfer to another pharmacy. No membership needed.
- Call Costco at 1-800-607-6861 and follow the prompts.
- Mail a letter to request a refill with your name, RXBin number (it’s on your CHPW member ID card), and phone number to:
- Costco Mail Order Pharmacy
802 134th St. SW, Suite 140
Everett, WA 98204-9935
- Costco Mail Order Pharmacy
- Fax the request with your name, RXBin number, and phone number to 1-877-258-9584.
Option 2: Your Community Health Center (CHC)
Check with your CHC to see if home delivery is available. Many HealthPoint locations offer it.Not sure where your CHC is? Check your CHPW Member ID card for your primary clinic name and phone number or find one near you.
Search CHCs ➔
Option 3: Express Scripts Pharmacy®
If you take a prescription medication regularly, you may be able to order from Express Scripts® Pharmacy.
How to use Express Scripts home delivery
For new prescriptions:
- Ask your doctor to send your prescription electronically to Express Scripts® Pharmacy, or
- Online register or log in to your Express Scripts account. Click the “Request an Rx” button on the right side of the home page.
To refill current prescriptions:
- Once logged in, check “My Medications” for prescriptions that are eligible for home delivery. If you have refills available, add them to your cart, and place your order.
Questions or need help?
Call Customer Service at 1-800-440-1561 (TTY: l 711), from 8 a.m. to 5 p.m., Monday to Friday.
Express Scripts: Manage prescriptions online
CHPW partners with Express Scripts to provide a large network of pharmacies and a range of covered prescriptions.
Create an account to manage your prescriptions, search pharmacies, set up delivery for ongoing prescriptions, and get safety information.
There’s no cost for CHPW Apple Health members.
Log in to Express Scripts Create account
Safety guidelines and support services
Know your rights and coverage: CHPW 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.
For more details about coverage, check your member benefit handbook or contact us at 1-800-440-1561 (TTY: 711) or email [email protected]
- Keep track of medication: Write down your medication, supplements, and over-the-counter products. Bring the list with you to all your appointments.View a medication list worksheet➔
- Recalled medication: If your prescription is recalled, contact the provider who prescribed it to you right away. Do not continue to take the recalled medication.Check recent drug recalls ➔
- Understand your prescriptions: Express Scripts offers safety information about your prescriptions, including possible side effects and harmful drug interactions.Go to Express Scripts ➔
- Help stop fraud: We participate in monitoring for pharmacy fraud and abuse. If you suspect misuse or overuse of pharmaceuticals, call Customer Service at 1-800-440-1561 (TTY: 711) Monday through Friday, 8:00 a.m. to 5:00 p.m. or at [email protected].
Frequently asked questions
My medication isn’t covered. What can I do?
- Ask your doctor if there are other similar options: Alternative medication may be available that is covered.
- Medication isn’t in the formulary: Request a coverage determination review by contacting Customer Service.
- Coverage denied by Express Scripts: You may appeal the decision with CHPW. How to file an appeal or grievance ➔
- Excluded drugs: To request a medication be covered that is not, send a request by completing the Exception to the Rule Request Form. Fax or mail it to CHPW.
I paid full price for a prescription at a retail pharmacy. Can I get reimbursed?
- First, check your plan’s formulary for restrictions on your medication. If there are no restrictions, ask for reimbursement.
- To request, print and complete a Prescription Drug Reimbursement form. Follow the instruction on the form to fax or mail it to Express Scripts. Or send your request online from your Express Scripts account.
I’m travelling and need a prescription filled. Where do I go?
- If you’re outside of Washington state, please contact our Customer Service team at 1-800-440-1561 (TTY: 711) Monday to Friday, 8:00 a.m. to 5:00 p.m. or email [email protected].
- After hours? Try our Nurse Advice Line at 1-866-418-2920 (TTY: 711).
- Prescriptions filled out-of-network aren’t usually covered. In an emergency, pharmacies may offer up to a 72-hour supply.
Are COVID-19 vaccines covered?
The Pfizer BioNTech, Moderna, and Novavax COVID-19 vaccines are covered as part of CHPW’s medication benefit at any location they are offered.
Become a CHPW member
Not a member? You deserve a plan that listens to you. Enroll in CHPW for your Apple Health coverage.
