Walgreens Is Now in Your Network

Johns Hopkins US Family Health plan has added all Walgreens pharmacies to your network — that’s 8,100 locations and growing. In addition to convenient locations, Walgreens has many digital tools to help you manage your medication and easily refill prescriptions.

  • You should have received a new member ID card as a result of this pharmacy network change. Please use the new card and discard the old one. If you have not received your new card, contact [best number].
  • Online coordination of benefits for pharmacy coverage will be available soon. If you have prescription coverage through another health insurance plan, your pharmacist will soon be able to submit your prescription online to both plans at the same time.
  • We will end our partnership with Rite Aid on 12/31/2018. Before this date, if you are still using Rite Aid for your prescriptions, we will contact you to help you find a convenient Walgreens. You will need to ask Rite Aid to transfer your prescriptions to Walgreens, they will not do this without a request from you.

Certain common vaccines such as Flu, Pneumonia and Shingles vaccines are available at select Walgreens pharmacies only.

You may contact customer service at 410-424-4528 or 1-800-808-7347 if you need assistance finding a network pharmacy.

Find a network pharmacy near you

Pharmacy & Prescription Drug Benefits

Formulary

Johns Hopkins USFHP utilizes the TRICARE pharmacy formulary. The formulary lists all of the prescription drugs that are covered under the TRICARE benefit. It is a tiered, open formulary, and includes generic drugs (Tier 1), preferred brand drugs (Tier 2), and non-preferred brand drugs (Tier 3). Each of these tiers represents a cost share that USFHP members are responsible for paying.

Use the TRICARE formulary search tool to find coverage and cost share details for a specific drug.

You can also find information about medications, including how to take them, possible side effects, and drug interactions.

Formulary changes

The formulary is updated on a regular basis to include tier changes and utilization (UM) requirements. Review the latest formulary changes.

Prior authorization

Some medications require prior authorization from our plan before they can be dispensed by your pharmacist. This helps us ensure that your prescriptions are medically necessary.

For a list of drugs that require prior authorization, refer to the TRICARE Prior Authorization page.

To initiate a prior authorization, your doctor must complete and fax the prior authorization form to the Johns Hopkins HealthCare Pharmacy department at 410-424-4037.

Step therapy

Step therapy is a process where we look for ways to provide our members the most cost-effective medication that is safe and clinically effective for their condition. The preferred prescribed medication is often a generic version that offers the best overall value in terms of safety, effectiveness, and cost. Non-preferred drugs are only prescribed if the preferred medication is ineffective or poorly tolerated.

Drugs subject to step therapy will be approved for first-time users only after they have tried one of the preferred agents as covered in the TRICARE formulary. When medically necessary, your doctor can request an exception to the step therapy requirement by submitting a prior authorization request.

Quantity limits

Quantity limits are established for certain drugs to ensure the medication is being used correctly. If your medical condition warrants a larger quantity of your medication than the listed quantity limit, your doctor should submit a prior authorization request.

Medical necessity

You can get non-formulary drugs at a network pharmacy or through home delivery at the regular formulary copay if medical necessity is established according to criteria established by the Department of Defense Pharmaceutical & Therapy (DoD P&T) Committee. Your doctor can assert medical necessity by submitting a prior authorization request.

Generic substitution

The DoD’s policy on generic drugs requires the pharmacy to substitute generic medications for brand-name medications when a generic equivalent is available. Brand-name drugs with a generic equivalent may be given only if your physician submits a prior authorization request and approval is granted by USFHP. In those cases, you will pay the brand name copayment. If you insist on having a prescription filled with a brand name drug when a generic equivalent is available, and medical necessity for the brand name drug for you has not been established, you will be responsible for the entire cost of the prescription.

Although generic drugs are chemically identical to their branded counterparts and are held to the same FDA standards for safety and performance as brand-name drugs, they sell for 30-75 percent less. You can save money on your co-payment by choosing generic drugs when applicable. Additional information on generic drugs is available on the FDA website.

Other covered medications

Our pharmacy program provides outpatient coverage to members for medications that are approved for marketing by the U.S. Food and Drug Administration (FDA) and that generally require prescriptions. Other covered medications include:

  • Compounded medications of which at least one ingredient is a legend drug
  • Insulin
  • Insulin syringes and needles
  • Glucose test strips
  • Lancets

Non-covered medications

Prescription medications that are used to treat conditions not currently covered by USFHP by statute or regulation are excluded from the pharmacy benefit.
Excluded medications include:

  • Drugs prescribed for cosmetic purposes
  • Fluoride preparations
  • Food supplements
  • Homeopathic and herbal preparations
  • Multivitamins
  • Over-the-counter products (except insulin, diabetic supplies, and select OTC products)
  • Weight reduction products
Filling your prescription

You may obtain your prescriptions at any Walgreens pharmacies nationwide or through home delivery.



Note: You may not obtain prescriptions from a military treatment facility while enrolled in the USFHP. Prescriptions that originated at a military treatment facility may not be transferable to Walgreens pharmacies.

Any prescriptions filled outside the USFHP Pharmacy network in a non-emergent situation may be subject to review to determine if the amount submitted should be reimbursed in full,  less applicable co-payment.  To obtain reimbursement, complete the Pharmacy Prescription Reimbursement Claim Form, and mail to the address provided on the form.

Home delivery

Home delivery is available to USFHP members for up to a 90-day supply of approved medications through Walgreens Pharmacy at Remington. Home delivery is best suited for medications you take on a regular basis. To obtain your prescription through home delivery, complete the mail order form and send it in with your new prescription. If you need a refill, please fill out and send in the mail order form along with your prescription number, plus a check or credit card number for your copayment. The mail order form may also be securely emailed to you through your HealthLINK@Hopkins account. Your prescription order will be processed promptly and most orders are received within two weeks. To ensure you receive a refill before your current supply runs out, reorder at least two weeks before you need your refill.

Walgreens Pharmacy
2700 Remington Ave.
Baltimore, MD 21211
Phone: 410-235-2128
Fax: 410-889-1609

Retail pharmacy pick-up

Fill and pick up your prescriptions at any of our network pharmacies nationwide without having to submit a claim. Through our retail pharmacy network, you can fill a 30-day supply of your everyday medications, or a 90-day supply of medications for a chronic condition, for the same copay as home delivery. To fill a prescription, present your Johns Hopkins USFHP Member ID card to the pharmacist with your prescription.  Your ID card contains important information to allow the pharmacy to process your claim correctly. You will be responsible for a portion of the cost of the medications, or copay. Copays are subject to change at TRICARE’s discretion. The TRICARE formulary contains three cost levels for USFHP members.

Use the TRICARE formulary search tool to see whether a specific drug is covered and its cost share.

Specialty medications

Specialty medications are usually high-cost, self-administered, injectable, oral, or infused drugs that treat serious chronic conditions. These drugs typically require special storage and handling, and may not be readily available at your local pharmacy. Specialty medications may also have side effects that require pharmacist and/or nurse monitoring. Many specialty medications (oral and injectable) are available through the retail pharmacy network.  However, some medications may not be available at all retail locations because the medication’s manufacturer limits the medication to specific pharmacies.  If your physician submits a request for use of a restricted distribution drug and we approve it, we will forward the request to a contracted specialty pharmacy. The specialty pharmacy will coordinate delivery of the medication to patient’s home or physician office.

Vaccines

Certain common vaccines such as Flu, Pneumonia and Shingles vaccines are available at select Walgreens pharmacies only. You may contact customer service at 410-424-4528 or 1-800-808-7347. You may also call the Walgreens pharmacy to see if they are able to administer vaccines and are participating in the USFHP pharmacy vaccine network.

Certain common vaccines such as Flu, Pneumonia and Shingles vaccines are available at select Walgreens pharmacies only. You may contact customer service at 410-424-4528 or 1-800-808-7347. You may also call the Walgreens pharmacy to see if they are able to administer vaccines and are participating in the USFHP pharmacy vaccine network.