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 an 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
Contact us

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 services.

Enroll with OptumRx Home Delivery

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

  • Access the OptumRx portal
  • 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

Questions? We invite you to review the OptumRX FAQ.

Read the FAQ for Commercial Members

Read the FAQ for Medicare Part B Members
Home Delivery for Commercial Members
Managing your Medications Online for Commercial Members

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


Drug Formularies

RMHP is pleased to cover a wide variety of medications for our Members. The Drug Formulary is a list of the covered medications for your plan with RMHP. Drug coverage is carefully determined with active participation from our RMHP physician and pharmacist committee. Formularies include all of this detailed information: 

  • 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 View Formulary changes for the Commercial Formulary
View 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 a Prior Authorization Request Online - Commercial & Medicaid Members
Good Health Prior Authorization Drug List

Good Health Drugs Requiring Step Therapy
Medicaid Prior Authorization Drug List
Medicaid  Drugs Requiring Step Therapy
View Printable Medicaid Prior Auth Drugs
View Printable Commercial Prior Auth Drugs
View Printable Medicare Part B Prior Auth Drugs
Submit a Formulary Exception Request Online
Brand Name Drug Request Form


Prescription Drug Reimbursement

 If you paid in full for a prescription medication that is eligible for reimbursement, complete and submit the appropriate form for reimbursement:

2018 Prescription Reimbursement Form
Access 2017 Pharmacy Information

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.


Let's Find You Great Health Insurance