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CHP+ Pharmacy

Learn more about your pharmacy benefit.

Many prescription medications from your doctor can be covered by CHP+.
Navitus Health Solutions helps with our CHP+ prescription drug benefit.

 

 

A formulary is a list of prescription drugs that we cover.

 

 

For these medications to be covered by CHP+, you need a prescription from your doctor.
Bring the prescription to a retail pharmacy in our network. Our CHP+ Pharmacy network is large.

 

 

Some CHP+ members may have a prescription medication copay.

 

Sign Up for the Free Navitus Member Portal

Sign up for the free Navitus member portal to:

  • See your member ID card
  • Compare medication prices
  • Learn more about medication
  • Find pharmacies near you
  • And more!

90-Day Supply

Some daily prescription medications may be able to get a 90-day supply of medication. Ask your doctor if your medication qualifies for this. Coverage guidelines and quantity limits may apply.

What is Synagis?

Synagis is a prescription shot of antibodies. It is given monthly to help protect high-risk infants from respiratory syncytial virus (RSV). Synagis is approved by the U.S. Food and Drug Administration (FDA).

The RSV season is from October 2022 to April 2023. You can get Synagis with CHP+. A home health agency can give it to you at home. If you have questions about this, talk to your doctor. They can find a Synagis form here.

Out of Pocket Prescription Reimbursement

Pre-HMO

If you paid for a prescription while you had CHP+, but before you enrolled in your health plan, you may ask for a refund.

Talk to the pharmacy where you got the prescription. Give them your receipt, state ID number, BIN (018902), and PCN (P303018902). If you don’t know your state ID number or if you need help, call the pharmacy liaison. Call them at 303-866-3588.

You have 120 days from the date the prescription was filled to ask the pharmacy for a refund. Refunds are not promised.

HMO

There may be times when you do not have your ID card at a pharmacy and you are charged for the full cost of a prescription medication. You may ask us to refund the cost of the prescription medication if you went to a pharmacy that is in our network and if you did not use another form of insurance or a discount card to pay.

If you pay the full cost for a covered prescription medication, please:

  • Ask for an itemized receipt. This will show that you paid for the medication.
  • Mail the itemized receipt, your name and address, and this this form to:

Colorado Access
Reimbursements
P.O. Box 17950
Denver, CO 80217-0950

We will look at what you send to us. We may ask for more details if we need them. This could be if the medication that you paid for is not on the formulary. Or if it needs preauthorization. This is also called preapproval.

This request must be done within 120 days from when you paid for the medication. If we need more details, we will ask the doctor who prescribed the medication. If your request is approved, you will be reimbursed. The amount will be based on the cost of the covered medication, minus any applicable copay.