Prior Authorization - Pharmacy

Prior Authorization - Pharmacy

RMHP covers a wide variety of medications. The RMHP Formulary Guidelines include information about RMHP drug coverage. RMHP drug coverage is determined with active participation from the RMHP physician/pharmacist committee (Pharmacy and Therapeutics Committee).

About Prior Authorization for Pharmacy

RMHP Outpatient Formulary Guidelines:

  • Include the coverage level for drugs (whether prior authorization is required, copayment tier, quantity limits, etc.)
  • Encourage the use of appropriate generic drugs
  • Are updated monthly
View our Formularies View Formulary changes for the Commercial Formulary
View Formulary changes for the RMHP Prime and CHP+ Formulary

Certain drugs must be prior authorized by the Pharmacy Department. To request prior authorization, please complete and submit the below form. You may also contact a representative at 970-248-5031 or 800-641-8921. When all required information is received by us, you will be notified of the authorization decision within 48 hours.

Submit a prior authorization request online
Good Health Prior Authorization drug list
Good Health Drugs Requiring Step Therapy
Medicaid and CHP+ Prior Authorization Drug List
Medicaid and CHP+ Drugs Requiring Step Therapy
View Printable Good Health Prior Auth Drugs
View Printable Medicaid and CHP+ Prior Auth Drugs

Step Therapy Drugs for RMHP DualCare Plus

Step therapy drugs for RMHP DualCare Plus Members can be found in the DualCare Plus Formulary by looking for drugs with the “ST” indicator.

View the RMHP DualCare Plus formulary