We care about your health and want you to be healthy! One of the ways to help manage your health is by using the medication that your doctor prescribes. Click on the navigation sidebar to learn about which drugs and products we cover, updates, drug costs, and authorizations. You can also access the CVS Member Portal.

​Effective 5/1/24, the Maryland Department of Health (MDH) is requiring all plans, including CareFirst BlueCross BlueShield Community Health Plan Maryland (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 1-800-730-8530, 8 AM to 5 PM, 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 1-800-345-5413 for assistance.

CareFirst CHPMD wants to make it easier to take your medications every day by offering some easy and NO COST options

90 day prescription fills
Available for most medications taken for chronic conditions and prenatal care. Medications must be generic (unless otherwise noted) and listed on our drug list (formulary). Select maintenance medications for Diabetes, high cholesterol, high blood pressure, and asthma are available for 90 day fill with a prescription written for 90 day supply. Ask your provider if a 90 day fill is right for you! Click here for the 90 day list.

Mail-Order Benefit
Effective 02/01/2019, members can use mail-order pharmacy for most chronic, non-opioid medications, including medications listed on our 90-day prescription fill list. These medications can be delivered directly to your home as long as you have a working phone number and an updated home address.

Members can contact CVS Caremark at 1-855-566-8397 to enroll in the mail-order benefit or for any for questions about the mail-order benefit.

“SYNC” Your Medications
Did you know you can schedule your prescriptions that you take every day to all be refilled together? That means you can pick them all up, once a month, and make less trips to the pharmacy.

How it works:

• Ask your local retail pharmacist if they offer this service and which of your medications can be included. Your pharmacist will work with your doctor(s) to make the arrangements for you. At a CVS Pharmacy, this service is called ScriptSync.

12 Month fill of Prescription Contraceptives
Maryland allows Prescription Contraceptives to be covered for up to twelve (12) month supply at a time if the prescription is written to be dispensed for 12 months at a time.

• The only exception is for medications filled for the first time. Initially, these can only be filled for up to two (2) months supply.

Opioids
For your safety, the number of opioid drug(s) to treat  your pain will be limited based on recommendations from the U.S. Centers for Disease Control and Prevention (CDC). You may see a reduced quantity of your opioid prescription(s) when you get them filled at a network pharmacy. The quantity you receive will vary based on the opioid drug your provider has prescribed.

Any opioid prescriptions for larger quantities greater than recommended by the CDC will require a prior authorization. There are additional limitations depending on whether you have used an opioid drug previously or whether you are using the opioid drug for short-term or long-term use for pain relief.

Blood Glucose Meters