Pharmacy Benefits for Enrollees

Information on Enrollee Pharmacy/ Drug Procedures

All enrollees must follow these procedures when getting their prescriptions filled. They must take that prescription to an approved pharmacy. Corresponding pharmacies can be found on the Pharmacy Locator.

If your enrollee has not yet received a new ID card and need to pick up or refill a prescription, they must have the pharmacy call Enrollee Services at (202) 821-1100 or (855) 872-1852 to look up their ID number.

Pharmacy/Prescription Instructions for the Enrollee:

• Choose a pharmacy listed on the CareFirst CHPDC network. We recommend that you should a Pharmacy that is close to your home or place of work. Give the Pharmacist the prescription along with your CareFirst CHPDC Enrollee ID Card.
• If you need assistance, please call Enrollee Services at (202) 821-1100 or (855) 872-1852 or TTY (202) 821-1152.
• In some occasions your doctor may need to get permission from CareFirst CHPDC for a drug that is not on the CareFirst CHPDC formulary.
• If at any time you need to get a prescription filled and the CareFirst CHPDC network pharmacy is closed, contact CareFirst CHPDC Pharmacy Enrollee Services at (202) 821-1100 or (855) 872-1852 or TTY (202) 821-1152 to obtain permission to get your medication at an out of network pharmacy.

Useful pharmacy/ prescription links:

• Provider / Pharmacy Locator
• PA Request and Other Required Material (PDF)
• Descovy Prior Authorization and Other Required Materials
• Non-formulary HCV treatment and Re-treatment Request and Other Required Material - (PDF)
• Opioid Prior Auth Request Form
• Travel Supply PA Request Form