To get the most out of your pharmacy benefits, there are a few key steps you should take:

When you visit your doctor, you may get prescriptions for certain medicines.

Ask your doctor if your medicines are covered by your Healthfirst plan or program. You can also learn which drugs are covered on our formulary (list of covered medicines), and if there is a copay when you pick up your medicines.

If the drug is on our list, check whether there are any limits such as:

• Step Therapy: We may ask you to try one medicine to treat your illness before we will cover a different medicine.

• Prior Authorization: Your pharmacist will need to provide extra information to us before we will cover the drug.

• Quantity Limits: There may be a limit to how much of the medicine we will cover.

In some cases, you may need to ask for an “exception” when you need a medicine we do not cover. If you have questions, talk to your doctor or give us a call. We’re here to help.

Take your prescription to one of our network pharmacies. If you have Medicaid, take it to any pharmacy that accepts Medicaid.

Give the prescription to the pharmacist. Also, give them your Healthfirst ID card (or Medicaid card).

If there is a copayment, you will need to pay the pharmacy. You should not pay more than your copayment, unless the drug is not covered by your plan or program