Drug and Pharmacy Information – Community Health Choice

If you are new to Community Health Choice (HMO D-SNP) and are taking a non-formulary drug, you are eligible for a temporary supply of your non-formulary drug. A non-formulary drug includes a drug that is not on Community’s formulary or a drug on the formulary that has special requirements. Our transition policy ensures that you can get a one-time temporary fill of at least one month’s supply* of the drug anytime during the first 90 days of your membership in Community Health Choice (HMO D-SNP). The prescription must be filled at a network pharmacy.

You and your doctor will receive a transition notice from us. This will allow you time to talk to your doctor or other prescriber about pursuing other options available to you within our formulary. Community Health Choice (HMO D-SNP) cannot continue to pay for these medications under the transition policy, even if you have been a member for less than 90 days following your one month transition supply.

*If your prescription is written for fewer days, you will be allowed to fill your drug multiple times to provide at least one month’s supply of medication. If you receive a transition supply, you will receive a letter from Community Health Choice (HMO D-SNP) notifying you that you have received a temporary supply of your prescription drug. Please refer to your Evidence of Coverage for more detailed information on the transition process.