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 700 pharmacies that includes retail and a mail service pharmacy (WellDyne Rx) available to all Members. Prescriptions up to a 90 day supply may be ordered from most local retail pharmacies and from WelldyneRX.

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 copayment discount. This discount will be the same whether you use a retail pharmacy or WellDyneRx mail service pharmacy. Please check your plan documents for details. Use our online Pharmacy Directory to find a local pharmacy close to your home or work, or contact our friendly Customer Service team.

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Mail Service Pharmacies

Mail Service pharmacies offer convenient home delivery of medications that you use on a regular basis.  RMHP is proud to partner with WellDyneRx Mail Service Pharmacy.

WellDyne Rx Mail Service Pharmacy

  • To enroll, print the  WellDyneRx Enrollment Form or visit welldynerx.com 
  • Log on to request a refill online or check the status of an order, or call WellDyneRX at 888-479-2000 to place or check the status of an order. 
  • Review  the WellDyneRx FAQ if you have any questions.

 

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 Commercial and Medicaid Formularies
View Formulary changes for Medicare Part D Formularies

 

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
Submit a Prior Authorization Request Online - Medicare Part D Members
Commercial and Medicaid Prior Authorization Drug List
Medicare Part D drugs requiring Prior Authorization
Commercial and Medicaid Drugs Requiring Step Therapy
Medicare Part D drugs requiring Step Therapy
View Printable Commercial & Medicaid Prior Auth Drugs
View Printable Medicare Part B Prior Auth Drugs

 

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:

Affordable Care Act Over-the-Counter Prescription Claim Form
Prescription Claim Form for Medicare Part D Members
Prescription Claim Form for Commercial and Medicaid Members

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.

 

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