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 will soon receive a new member ID card as a result of this pharmacy network change. Please begin using this new ID card once you receive it.
- Online coordination of benefits for pharmacy coverage will be available soon. If you have prescription coverage through another health insurance plan, your pharmacist will be able to submit your prescription online to both plans at the same time.
- We will end our partnership with Rite Aid in the coming months. Before Rite Aid leaves our network, we will contact you if you are still using Rite Aid for your prescriptions. We will help you find a convenient Walgreens.
Certain common vaccines such as Flu, Pnumonia and Shingles vaccines are available at select Walgreens pharmacies only.
You may contact our customer service unit at 410-424-4528 or 1-800-808-7347 if you need assistance identifying a network pharmacy.
Pharmacy & Prescription Drug Benefits
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.
You can also find information about medications, including how to take them, possible side effects, and drug interactions.
The formulary is updated on a regular basis to include tier changes and utilization (UM) requirements. Review the latest formulary changes.
Some medications require prior authorization from our plan before they can be dispensed by your pharmacist. This helps us ensure that the medication your doctor is prescribing you is 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 410-424-4607.
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 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.
You can get non-formulary drugs at a network pharmacy or through home delivery at the regular formulary copay if medical necessity, criteria established by the Department of Defense Pharmaceutical & Therapy (DoD P&T) Committee, is met. Your doctor can assert medical necessity by submitting a prior authorization request.
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 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:
- Insulin and diabetic supplies
- Tobacco cessation products covered by the tobacco cessation benefit
Other OTC drugs and supplies covered by the pharmacy benefit:
- Cetirizine tablets
- Fexofenadine tablets
- LevonorgestrelEmergency contraceptive used to prevent pregnancy. It’s also known as Plan B. It’s available to all beneficiaries for free without a prescription (Plan B One-Step Emergency Contraceptive).
- Loratadine tablets
- Omeprazole (generic of Prilosec OTC)
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
- Over-the-counter products (except insulin, diabetic supplies, and smoking cessation products)
- Weight reduction products
Filling your prescription
You may obtain your prescriptions at any of the Rite Aid or 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 Rite Aid or Walgreens pharmacies.
Any prescriptions filled outside the USFHP Pharmacy network in a non-emergent situation will be reviewed for medical necessity and if approved, will be reimbursed at the USFHP contracted rate less applicable co-payment.
Home delivery is available to USFHP members for up to a 90-day supply of approved medications through Rite Aid, now a 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.
2700 Remington Ave.
Baltimore, MD 21211
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. You will be required to make a copay at the time of service. The copay levels are printed on your ID card. Your ID card also contains important information to allow the pharmacy to process your claim correctly.
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.