Pharmacy

Prescription medication can be a critical part of your health care. That's why Community Health Plan makes it easy for you to get your prescriptions filled. We have more than 1,000 participating pharmacies throughout Washington State, including many pharmacy chains and neighborhood pharmacies.

Community Health Plan uses a certain list of covered drugs, or formulary. The Community Health Plan Pharmacy and Therapeutics Committee, composed of providers and pharmacists, chooses FDA-approved drugs for the formulary based on medical studies and research.

To get a current list of pharmacies in the Healthy Options/CHIP, Basic Health, or Disability Lifeline (GA-U) network or to find out which drugs are on the formulary:

  • Community Health Plan members use the Express Scripts (ESI) Access Your Account tool. If you are a first-time user, please use the ESI Activate Your Account tool. The ESI tool can also help you find out about copayments and general drug and health information.
  • Contact the Community Health Plan customer service team at 1-800-440-1561 (toll free) or email customercare@chpw.org. If you are hearing or speech impaired, please call TTY 1-866-816-2479 (toll free) or local 206-613-8875.


Community Health Plan follows federal laws that set standards to guarantee safe and effective pharmacy services. You have the right to know what pharmacy services are covered by your plan. If you would like more information or a copy of Community Health Plan pharmacy coverage policies or benefits:


Things to Remember

Always show your ID. To get Community Health Plan prescription benefits, you must show your Community Health Plan ID card and have your prescriptions filled at a pharmacy in our network. For more information about your Community Health Plan ID card, see the Medical Benefits Summary for your plan: Basic Health, Healthy Options and CHIP, or Disability Lifeline (GA-U).

Prior authorization. Before we pay for certain drugs, you must get an approval from Community Health Plan. This is called prior authorization. See our list of drugs that need a prior authorization, or contact us. As new products become available or new indications are given for specific circumstances or protocols, Community Health Plan reserves the right to make additions or deletions to the list of drugs that require prior authorization.

Maximum quantity limits are required on some drugs to ensure safe use.

Use of half tablets is recommended on certain drugs. The pharmacy will give you a tablet splitter with no copay required from you when you present a prescription for a drug taken in half tablets.

Prescription Drug Claim Form

For information about patient safety and managing your medications, see:


Pharmacy fraud and abuse. Community Health Plan monitors the safe use of pharmaceuticals through a fraud and abuse program and reserves the right to limit a member’s provider and pharmacy selection if overuse or misuse has been identified.

Important: The formulary search does not apply to Medicare Advantage Plan members. If you are a Medicare Advantage member, see the Medicare Advantage Plan formulary.