Pharmacy

Keystone First – CHIP pharmacy coverage provides clinically appropriate, medically necessary medications for all of our CHIP enrollees.

Please use the navigation options at left for greater detail and helpful links, including information regarding:

Formulary

The Keystone First – CHIP drug benefit has been developed with the Pennsylvania Department of Human Services to cover Medically Necessary prescription products.

Pharmacy directory

Keystone First – CHIP has a proprietary retail pharmacy network to provide Enrollees a means to access their prescription drug benefit. Outpatient drugs must be dispensed through Keystone First – CHIP network pharmacy providers.

Prior authorization

Prior authorization is required for medications that are not in the formulary, not normally covered, or that have been indicated as requiring prior authorization.

• Find a pharmacy (link to pharmacy directory page on pharmacy section of the site)
• Drug formulary  (link or pdf provided by pharmacy team)
• complete list of specialty medicines   (link or pdf provided by pharmacy team)
• list of network specialty pharmacies   (link or pdf provided by pharmacy team)
• covered over-the-counter medicines   (link or pdf provided by pharmacy team)