About Your Prescription Drug Coverage

About Your Prescription Drug Coverage

Whether you have a one-time illness or a chronic condition, RMHP knows the proper treatment and medication is of the highest importance. Read on to learn more about what we offer with our prescription coverage.  If you still have questions, we're happy to help.

Retail and Home Delivery Pharmacies

We know our Members need access to their prescriptions in a timely fashion, so RMHP offers a pharmacy network of more than 750 pharmacies that includes retail and the OptumRX Home Delivery Pharmacy available to all Members. Prescriptions up to a 90 day supply may be ordered from most local retail pharmacies and from OptumRx Home Delivery.

Retail Pharmacies

Retail pharmacies are ideal for one-time prescriptions or those prescriptions needed immediately. Most retail pharmacies will fill your maintenance prescription for a 90 day supply at your request, and you may receive a copay discount. This discount will be the same whether you use a retail pharmacy or OptumRx home delivery pharmacy. Please check your plan documents for details.  Some exclusions apply.  Use our online Pharmacy Directory to find a local pharmacy close to your home or work, or contact our friendly Customer Service team.

Find a pharmacy

RMHP DualCare: Find a pharmacy

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Home Delivery Pharmacies

Home Delivery pharmacies offer convenient home delivery of medications that you use on a regular basis.  RMHP is proud to partner with OptumRx Home Delivery Pharmacy.

Already Enrolled?

You can order a refill for a prescription with OptumRx Home Delivery Pharmacy by accessing the OptumRx portal.

Access OptumRx

Not Yet Enrolled? Sign up for OptumRx Home Delivery

You can place a home delivery order with OptumRx by taking any of these actions:

  • Access the OptumRx portal.  You can also access the OptumRx portal by logging into MyRMHP.
  • Access OptumRx
  • Have your doctor send an electronic prescription to OptumRx.
  • Call OptumRx home delivery.
    • Commercial Members call 844-368-8726
    • RMHP Prime, CHP+, and Medicare Part B Members call 855-473-8889
  • Download and complete the New Prescription Mail-In Order Form
  • Download the form

Specialty Pharmacies

Specialty prescription medications are usually high-cost medications that need special handling. We’re proud to partner with BriovaRx® as our preferred specialty pharmacy. With BriovaRx, you’ll have access to experienced pharmacists and nurses who can provide information about why your medication was prescribed, how it works, and how to administer and store it. Your medication will be shipped wherever you need it — in safe, temperature-controlled, and tested packaging.

If you have specialty medications you would like to fill through BriovaRx, you can:

  • Call 855-4BRIOVA (855-427-4682)
  • Visit briovarx.com

Access BriovaRx

We're Here to Help

If you have questions, just ask.  We can help you learn more about:

  • Your prescription
  • Prescription costs
  • Drug interactions
  • Side effects
  • The availability of generic substitutes

We can also help you with a medication review. Our pharmacists are also available to review your current medications and identify potential drug interactions or more cost-effective alternatives. To learn more, please contact us at 970-255-5677 or toll free 877-288-5773, or email us at RxMedReview@rmhp.org.

Drug Formularies

  • Copayment tiers
  • Quantity limits for medications (if applicable)
  • Prior authorization requirements for medications (if applicable)
  • Drugs that are not covered
  • Drugs that may be subject to special Affordable Care Act coverage

View our drug formularies

Download formulary changes for the Good Health formulary

Download formulary changes for the RMHP Prime and CHP+ formulary

Prior Authorization

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 an electronic prior authorization request
Download Good Health prior authorization drug list
Download Good Health drugs requiring step therapy
Download Medicare Part D prior authorization form
Download RMHP Prime and CHP+ prior authorization drug list
Download RMHP Prime and CHP+ drugs requiring step therapy
View printable RMHP Prime and CHP+ prior auth drugs forms
View printable Good Health prior auth drugs
View printable Medicare Part B prior auth drug forms
Submit an electronic formulary exception request
Download brand name drug request form

Step Therapy Drugs for RMHP Dual Care Plus

Step therapy drugs for RMHP DualCare Plus Members can be found in the DualCare Plus Formulary, or list of covered drugs, by looking for drugs with the “ST” symbol by them. Step therapy drugs may be effective, lower-cost drugs that treat the same medical condition as a drug you currently use. You may be required to try one or more of these other drugs before the plan will cover your drug.

View the RMHP DualCare Plus formulary

Eligible Over-the-Counter and Prescription Drug Reimbursement

If you paid in full for an Over-the-Counter or prescription medication that is eligible for reimbursement, complete and submit the Prescription Drug Reimbursement Form:

Prescription Reimbursement Form

Pharmacy Library

Use these resources to learn more about medication costs and generic drugs.

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