If you are traveling within the United States and territories and become ill, or lose or run out of your prescription drugs, remember that Capital Health Plan (CHP) has over 50,000 retail pharmacies in our pharmacy network. To find a pharmacy simply check our Pharmacy Locator or call Member Services at 850-523-7441 or 1-877-247-6512 (TTY 850-383-3534 or 1-877-870-8943) 8:00 a.m. – 8:00 p.m., seven days a week, October 1 – February 14; 8:00 a.m. – 8:00 p.m., Monday – Friday, February 15 – September 30 for the closest location.
Getting coverage when you travel or are away from the Plan's service area.
Generally, CHP covers drugs filled at an out-of-network pharmacy in limited circumstances when a network pharmacy is not available.
CHP will not pay for any prescriptions that are filled by pharmacies outside of the United States and territories, even for a medical emergency.
If you need a prescription because of a medical emergency or for urgent care.
CHP will cover prescriptions that are filled at an out-of-network pharmacy if the prescriptions are related to care for a medical emergency or urgent care. In either of these situations, you will have to pay the full cost (rather than paying just your copayment) when you fill your prescription. Complete the attached Prescription Drug for Reimbursement Form or contact Member Services at the numbers listed on this page to request reimbursement for CHP's share of the costs.
Other times when you can get your prescription covered if you go to an out-of network pharmacy.
CHP will cover your prescription at an out-of-network pharmacy if at least one of the following applies:
- If you are unable to obtain a covered drug in a timely manner within our service area because there is no network pharmacy within a reasonable driving distance that provides 24-hour service.
- If you are trying to fill a prescription drug that is not regularly stocked at an accessible network retail pharmacy (including high cost and unique drugs).
- If you are getting a vaccine that is medically necessary but not covered by Medicare Part B and some covered drugs that are administered in your doctor's office.
For more information:
For more detailed information about your Capital Health Plan Medicare Advantage (HMO) prescription drug coverage, please review the Capital Health Plan Advantage Plus and Capital Health Plan Preferred Advantage Formulary, the Capital Health Plan Advantage Plus Evidence of Coverage or the Capital Health Plan Preferred Advantage Evidence of Coverage or call Member Services at one of the telephone numbers listed on this page.