Drug List
This plan uses a formulary. Our formulary is a preferred list of thousands of drugs selected to meet the needs of Medicare beneficiaries.
Our formulary is reviewed and updated on a regular basis by medical and pharmacy professionals. If the formulary changes, affected enrollees will be notified before the change. Click here for Transition process "What do I do before I can talk to my doctor about changing my drugs or rquesting an exception?"
All Denver Health Medical Plan formularies use tiers, or levels, to show you which drugs are available at which prices. It is important to note that generics are almost always the most cost effective choices – they usually appear on Tier 1, at the lowest prices. Generic drugs thave the same active ingredients as the brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.
Medicare Choice (HMO SNP) and Medicare Select (HMO) contract with pharmacies that meet or exceed CMS requirements for access in your area and more than 60,000 pharmacies nationwide through the Caremark/CVS Network..
Out of Network Coverage
If you need to access a pharmacy when traveling outside our service area, you may contact Member Services to locate a pharmacy at 1-877-956-2111. Our hours of operation are from 8:00 a.m. - 8:00 p.m. seven days a week. TTY Users should call 1-866-538-5288. If you use a nonparticipating pharmacy you will most likely have to pay for your prescription. Please save your receipt and submit it to us for reimbursement at:
Denver Health Medical Plan
777 Bannock Street, MC 6000
Denver, CO 80204
Medication Therapy Management
Medicare Choice and Medicare Select offer a CMS-approved Medication Therapy Management Program (MTMP) for members with multiple chronic diseases who take multiple medications. It should be noted that the MTMP, therefore, has limited eligibility criteria and is not considered a benefit. We encourage you to contact our Member Services department for additional information at 303-602-2111 or toll-free at 1-877-956-2111. TTY/TDD users should call 1-866-538-5288. We are available from 8:00 a.m. to 8:00 p.m. Mountain Time, seven days a week.
Click here to download formulary list for Denver Health Medical Plan, Inc. Prescription D Plans.
Click here to download Prior Authorization Request Form
Click Here to download Prior Authorization Documents