Prescription Drug Coverage
Please click the links below to review your Medicare Part D prescription drug benefits. Please use the Pharmacy Locator to find pharmacies in the CHP network.
Last updated: 10/01/2011
Formulary (Drug List)
A formulary is a list of covered drugs that represents the prescription therapies believed to be a necessary part of a quality treatment program. The formulary is selected by Capital Health Plan in consultation with a team of health care providers.
- CHP Medicare Advantage Formulary (pdf 2.58 MB)
- Formulary Search Tool
- Prior Authorization Document (pdf 715.70 kB)
Formulary Change Notice
Capital Health Plan may add or remove drugs from our Medicare formulary during the year. We will post a new Formulary Change Notice (pdf 53.80 kB) each month.
Retail Pharmacies
Capital Health Plan Medicare Advantage (HMO) members have access to over 62,000 retail pharmacies nationwide. Access meets or exceeds standards set by the Centers for Medicare and Medicaid Services (CMS).
Mail Order Pharmacy
Capital Health Plan will cover certain kinds of drugs through the plan's network mail-order service.
Medication Therapy Management Program
Capital Health Plan offers Medication Therapy Management to eligible members.
Home Infusion Pharmacies
You may have coverage for home infusion therapy.
Long-Term Care Pharmacies
In some cases, residents of a long-term care facility may access their prescription drugs through their long-term care pharmacy.
Out-Of-Network Pharmacies
If you take a prescription drug on a regular basis and you are going on a trip, be sure to check your supply of the drug before you leave.
Transition Process
Sometimes you are taking a drug that is not on our formulary. Check this section for details on what the transition process is.
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