Prescription Drugs - Community Health Plan of Washington - Medicare Advantage

Prescription drug coverage is included on CHPW Medicare Advantage (MA) Plans 1, 2, 3, 4 and Dual Plan (SNP). Our coverage uses a tiered cost-sharing system. You pay either a fixed copay amount or a percentage of the total cost.

Prescription Cost-Sharing Tiers

Tier 1 represents the lowest cost generic drugs and Tier 5 represents the highest cost brand drugs and potent drugs that may require monitoring.

  • Tier 1: Preferred Generic – includes lowest cost preferred generic drugs
  • Tier 2: Generic – includes preferred generic drugs
  • Tier 3: Preferred Brand – includes preferred brand drugs and non-preferred generic drugs
  • Tier 4: Non-Preferred – includes non-preferred brand drugs and non-preferred generic drugs
  • Tier 5: Specialty Tier – includes high cost and brand name drugs

Prescription Pricing

We can help you decide which tier of coverage you need based on the current medications you take. If you’re a current member, please call 1-800-942-0247 (TTY: 711). For prospective members, please call 1-800-944-1247 (TTY: 711). We’re here for you seven days a week, 8:00 a.m. to 8:00 p.m.

To discuss which prescription medications you need, contact your primary care provider or pharmacist.

And keep in mind—for the lowest copays, use a preferred pharmacy.

2022 MA Dual Plan (HMO SNP)

Please see the prescription drug coverage page for more information about which specific medications are covered.

2022 MA Plans 1, 2, 3, 4 (HMO)

2021 MA Plans

2021 Prescription Tier Pricing
We can help you decide which tier coverage you need based on the current medications you take. Discuss your prescription drug options with your primary care provider or your pharmacist. For the lowest copay amounts, use the preferred pharmacy.

Prescription Benefits for MA Dual Plan (HMO SNP)

Please read the prescription drug coverage page for more information about which specific medications are covered.

Get the most of your prescription benefits

Additional highlights include:

  • 90-day supply of select medications used to treat chronic conditions (e.g., high blood pressure, diabetes, depression)
  • Free home delivery
  • Searchable and printable prescription drug formularies (lists of covered drugs)
  • Coverage accepted at more 1,000 Washington State pharmacies and more than 50,000 pharmacies nationwide

Eligibility criteria may apply. ➔ Learn more about Prescription Drug Coverage.

We’re here to help.

To ask questions, request print copies of materials, and more, contact Customer Service at 1-800-942-0247 (TTY: 711), 8:00 a.m. to 8:00 p.m., 7 days a week.

DID YOU KNOW...?

Stay on Top of Your Prescriptions

Woman grabbing a prescriptionDid you know that certain prescription medicines are available as a 90-day supply? Medicine that you take on a long-term basis to manage your health is called a “maintenance drug.” A 90-day supply makes it easier to keep taking the medicine you need to feel your best. You may also be eligible to receive your long-term medications through free home delivery.

LEARN MORE

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Phone: 1-800-944-1247
Email: [email protected]

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🕬 Holiday Hours

CHPW Medicare Advantage offices and customer service center will be

 

closed Thursday, November 25, 2021.

 

Sales Representatives and Customer Service will resume business hours

(Monday through Friday, 8 a.m. to 8 p.m.) on Friday, November 26.