Pharmacy benefits for the Texas CHIP program are determined by Medicaid/CHIP Vendor Drug Program (VDP) and are administered by the Blue Cross and Blue Shield of Texas (BCBSTX) CHIP program. This includes coverage for selected prescription and selected medical supplies. This plan goes by a list of preferred drugs. The Drug List (also called a formulary) is a list showing the drugs that can be covered by the plan. The list includes generic and brand drugs and medical supplies.
As a CHIP member, your copayments will be listed on your ID card for the items on the Drug List. Those items will be covered as long as you:
- have a medical need for them
- have a prescription from your doctor for them
- fill the prescription at a network pharmacy
- follow the plan rules
Certain drugs on the list may need a prior authorization and your doctor will need to request approval before these drugs may be covered. If your doctor wants you to have a drug that is not on the list, he or she can request approval for that drug. For some drugs, the plan limits the amount that will be covered. You can find out if your drug has any added conditions or limits by looking at the Drug List.
There are many ways your doctor may submit a prior authorization request
- Submit online requests
- Call 1-855-457-0407
- Fax in completed forms at 1-877-243-6930. View Prescription Drug Forms
To protect your health and keep you safe, make sure your doctor and pharmacist know all the medicines you are taking, including OTC drugs.
Home Delivery Pharmacy
Are there medicines that you take regularly or long-term? Regular medicines are taken sometimes more than once a day or many times a week. Regular medicines can also be taken long-term, for more than 3 months, and may treat chronic conditions like high cholesterol, high blood pressure, asthma or depression and anxiety. You can now order many of your regular or long-term medicines through the AllianceRx Walgreens+PRIME home delivery pharmacy service and have them delivered directly to your home.
The home delivery pharmacy service gives you:
- Three ways to order refills: online, by phone or through the mail
- A choice to get a text or email notice to let you know when they have received your order, and to let you know when your prescription has been mailed
- Up to a 90-day supply of your regular or long-term medicine mailed at one time
Read the Home Delivery Pharmacy brochure for more information and fill out the Home Delivery Registration and Prescription Order Form to get started.
Our network has many pharmacies for you to use.
Prime Therapeutics, LLC, is the pharmacy benefit manager for Blue Cross and Blue Shield of Texas.