MRMIP pharmacy and prescription drugs
Your benefits include a wide range of prescription and over-the-counter (OTC) medicines. You can even have your medicines delivered to your home. We work with CarelonRx to provide these pharmacy benefits.
Find a MRMIP pharmacyHow to fill a prescription
Bring your member ID and prescription to a pharmacy in your plan. A doctor can also call in the prescription for you. MRMIP members have the option to use any pharmacy, but costs are much lower if you use a plan pharmacy.
It is good to use the same pharmacy each time you fill a prescription. This way, your pharmacist will know about problems that may happen when you’re taking more than one prescription. If you use another pharmacy, you should tell the pharmacist about all medicines you or your child are taking.
Have your medicines mailed to you
Order your medicine by calling Pharmacy Member Services at 833-255-0646 (TTY 711) anytime, day or night. You can choose to have the prescription mailed to you or shipped to a local CVS retail pharmacy where you can pick it up. If you do that, you can track the order until it arrives.
Prescription drug home delivery
You can receive many prescription drugs shipped directly to your home through CarelonRx Pharmacy.
Your costs
Copays are a set dollar amount you pay for a covered service, like filling a prescription.
There is a $10 copay for generic drugs and a $35 copay for brand-name drugs (up to a 100-day supply) when you fill your prescription at a pharmacy in your plan.
Drug coverage information
Find your medicine in the formulary (drug list)
The formulary is a list of all brand-name and generic drugs available in your plan. All drugs on the formulary are covered, but some drugs may require preapproval before the prescription can be filled. Our Pharmacy and Therapeutics (P&T) Committee reviews and recommends what drugs should be in the formulary. They choose the medications for our drug list based on things like how safe the drug is, how well it works, and how much it costs.
Do you see your medication listed?
If you don’t see your medicine listed in the formulary, you may ask for an exception at submitmyexceptionreq@anthem.com. You will be asked to supply a reason why it should be covered, such as an allergic reaction to a drug.
Prior authorizations (preapprovals)
Some medicines need a preapproval, or an “OK,” from Anthem before your doctor can prescribe them. The preapproval process helps us make sure that you are taking medications safely and correctly.
Here are some reasons that preapproval may be needed:
- There is a generic or pharmacy alternative drug available.
- The drug could be misused or abused.
- There are other drugs that should be tried first.
- The drug has a high side effect potential.
- The drug is prescribed at a higher dosage than recommended.
- There is additional information needed about your condition. We need to match it to the U.S. Food and Drug Administration (FDA) approval of the drug and/or studies of effectiveness.
For medicines that need preapproval, your provider will need to contact us. Anthem will review the request and give a decision within 24 hours. If you need your medicine right away, you may be able to receive a 72-hour supply while you wait. Please call Pharmacy Member Services 24 hours a day, seven days a week at 833-214-3605 (TTY 711).
Do you need help?
If you misplace your medicine or it is stolen, contact your provider. They will work with the pharmacy and Anthem to review your case and replace the medicines as needed.
If you have any questions about your pharmacy benefit, call Pharmacy Member Services 24 hours a day, seven days a week at 833-214-3605 (TTY 711).
Pharmacy forms
Prescription Drug Home Delivery Form
CarelonRx Notice of Privacy Practices:
How to receive specialty medications
If you have a complex or chronic health condition that requires special medicine, we can help. We partner with CarelonRx Specialty Pharmacy and other pharmacies to meet all your specialty medication needs.
Learn about specialty pharmacy