Pharmacy Information

Over-the-counter (OTC) items may be obtained through the CHPMD Formulary with prescription from a provider. For more information, review our Member Handbook.

See our Drug List for approved medications included in CareFirst CHPMD's pharmacy benefit.

CareFirst CHPMD's Pharmacy and Therapeutics Committee helps create and manage our list of covered drugs and products.

There are a few reasons that a medication might require prior authorization or approval by your plan before it can be filled at the pharmacy. It may be because the medication is not on the Drug List or that your doctor requested more pills than usually prescribed.

Effective 5/1/24, the Maryland Department of Health (MDH) is requiring all plans, including CareFirst CHPMD, to charge a copayment amount for some pharmacy services. The new pharmacy copayment will be:

• $1.00 for generic drugs, preferred/formulary brand drugs and HIV/AIDS drugs
• $3.00 for non-preferred/non-formulary brand drugs

Certain drugs, such as mental health and substance use disorder medications, are covered by the MDH, and copayment may apply to those drugs. All other copayment policies will remain the same. Pregnant women, American Indians, individuals under the age of 21, individuals receiving hospice care and family planning drugs such as birth control will remain excluded from the above copayment.

If members have questions about this information, they can call CareFirst CHPMD at 410-779-9369 or toll-free at 800-730-8530, 8 a.m. to 5 p.m., ET, Monday through Friday. TTY users, please dial 711.

In accordance with Medicaid regulations (COMAR 10.09.03.03.O), providers may not deny services to any participant because of the individual’s inability to pay the copayment. If a member is unable to pay a drug copay, the dispensing pharmacy must contact the CVS Help Desk at 800-345-5413 for assistance.

Call CareFirst CHPMD.

410-779-9369
800-730-8530

8 a.m.–5 p.m., Monday–Friday

TTY users, please dial 711.
Members who don't speak English can call Member Services and ask for an interpreter.

Unused medicine can find its way into the wrong hands. It's dangerous and can be tragic. Drop off expired and unwanted medications at CVS drop boxes for safe disposal.

One Touch by LifeScan is the preferred covered blood glucose meters and test strips. Find out more. | Meter Guide