Pharmacy
Ensuring Access to Safe and Effective Medications: At NH Healthy Families we are empowered to navigate healthcare complexities with partners who provide innovative and tailored pharmacy solutions to our members. These partnerships improve member health outcomes and allow for cost effective treatments. These partnerships also ensure you have access to essential medications and receive personalized clinical programs.
NH Healthy Families offers tailored clinical programs that drive medication adherence and reduce medication errors. These programs are designed to improve health outcomes. We help you manage chronic conditions and ensure you receive the right medications at the right time to get and stay healthy.
Medication Therapy Management: Our Medication Therapy Management programs help members to understand and manage their medications, supporting you to optimize health regimens and improve therapeutic outcomes.
Comprehensive Medication Review: As a member of NH Healthy Families, you are eligible for a Comprehensive Medication Review at no cost to you. The goal of the program is to create a plan to help your medications work better for you, reduce side effects, and possibly save you money. If you would like more info call 1-866-769-3085 to speak with our pharmacy team.
Our pharmacy program leverages an extensive network, which provides access to a range of retail, mail-order, and specialty pharmacies. This ensures our members receive their medications conveniently and
cost-effectively. We work closely with our pharmacy program with you, our NH Healthy Families member in mind. Together, we prioritize transparency in pricing, reduce the total cost of care, promote value, and ensure affordability for you. Members have the option to receive a 90-day supply of their maintenance medications at in-network pharmacies.
NH Healthy Families covers certain prescription and over-the-counter drugs when prescribed by a NH Healthy Families provider. The pharmacy program does not cover all drugs. Some require prior authorization. Some drugs have limitations on age, dosage or maximum quantities.
The Preferred Drug List (PDL) is the list of drugs covered by NH Healthy Families. NH Healthy Families works closely with NH DHHS, providers and pharmacists to ensure that medications used to treat a variety of conditions and diseases are covered. The PDL applies to drugs you receive from retail pharmacies. The PDL is continually evaluated by the Pharmacy and Therapeutics Committee to promote the appropriate and cost-effective use of medications.
Click the links below to view the NH Healthy Families Preferred Drug List (PDL) documents:
View the Preferred Drug List (PDF).
Machine-Readable File (JSON) document:
- NH Healthy Families Preferred Drug List Machine Readable File (JSON)
In accordance with the CMS Transparency in Coverage Final Rule (84 FR 65524), NH Healthy Families has made public the preferred drug list in a machine-readable file format (MRF).
If a prescription drug you take is no longer preferred, you will be notified by your doctor, Managed Care Plan, or pharmacy. You may need to change your current drug(s). You can also ask your prescriber to submit a prior authorization request to stay on your current drug(s). If you receive a letter in the mail from NH Healthy Families, make sure to review the letter carefully. You should discuss this information with your prescriber at your next visit or call your prescriber’s office. If you go to the pharmacy to refill your prescription before your next visit, you might be told that your drug needs prior authorization. We will work with your prescriber to cover a drug that meets your needs. You will not lose drug coverage. Please note that you will also continue to use the same Medicaid ID.
Copayments may apply to your medications.
If you have questions or problems with your prescription, call NH Healthy Families member services by dialing the toll-free number 1-866-769-3085 on your Medicaid ID card.
What is a Specialty Medication?
A specialty drug is a prescription drug that needs special handling, administration, or monitoring. These are usually only ordered through a specialty pharmacy.
What is a Specialty Pharmacy?
A specialty pharmacy provides services and medications needed to treat members with chronic, complex or rare conditions. The medication dispensed by specialty pharmacies is often considered high-touch or high-cost. The services provided by specialty pharmacies are done by highly trained professionals and are usually more extensive than regular retail pharmacies offer. Specialty pharmacy services can include clinical help, such as training on how to take medication. Or help finding and applying for financial assistance, like copay assistance programs.
Access to Specialty Medications
Through our specialty pharmacy services, we offer support for high-cost medications and complex therapies. We ensure members have access to the treatments you need with the guidance of a dedicated pharmacy team.
Your Preferred Specialty Pharmacy is AcariaHealth
AcariaHealth is a national specialty pharmacy dedicated to transforming lives through compassionate care. They focus on enhancing the health and outcomes of people with complex medical conditions. AcariaHealth
takes a collaborative approach to care. They work closely with you and your healthcare providers to tailor treatment programs to meet your unique needs.
Contact AcariaHealth
P: 1-800-511-5144 (TTY 711)
F: 1-877-541-1503
Learn more about AcariaHealth at AcariaHealth.com.
You can have your prescriptions filled at a network pharmacy. At the pharmacy, you will need to give the pharmacist your prescription and your NH Healthy Families ID Card.
To find a pharmacy that is in the NH Healthy Families network, you can use the Find a Provider Tool. Type in your city or zip code. Then click Update. Choose Other and type the name of your pharmacy. You can also select the pharmacy type in the Select Specialty area. Only those pharmacies in the NH Healthy Families network are listed.
Our pharmacy program takes a personalized, community-focused approach to benefits, tailoring solutions to the unique needs of providers and members. This approach enhances care coordination, improves clinical outcomes, and reduces operational risks, fostering collaboration that drives better patient satisfaction and care delivery.
Mail-Order Benefits:
NH Healthy Families offers a mail-order pharmacy service that allows members to receive up to a 90-day supply of medications delivered to their door, saving them time and money. This service increases medication adherence while offering cost savings.
Get in Touch: For more information about our pharmacy program, contact us at: 1-866-769-3085 TDD/TTY: 1-855-742-0123.