NH Healthy Families is committed to providing appropriate, high-quality, and cost-effective drug therapy to all NH Healthy Families members. NH Healthy Families covers prescription medications and certain over-the-counter medications with a written order from a NH Healthy Families provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services are covered as well.
- NH Healthy Families Medical and Pharmacy Policies
- Opioid-Analgesics Policy (Morphine Equivalent Dosing) (PDF)
Use our Medicaid Preferred Drug List (PDF) to find more information on the drugs that are covered.
**Note: In response to the COVID-19 Pandemic NH Healthy Families wants to ensure our members’ prescription needs are met. For those members impacted by COVID-19 the pharmacy can place a one-time override for an early refill rejection on non-controlled substances. In order to place this override please have your pharmacy reach out to the pharmacy help desk via the phone number located on the back of your membership card. For controlled substances please reach out to NH Healthy Families at 866-769-3085, Monday through Friday 8 a.m. to 5 p.m. and ask for the pharmacy department.
Members have the option to receive a 90-day supply of their maintenance medications at in-network pharmacies.
NH Healthy Families also has in network mail-order pharmacies available to our membership to ensure timely delivery of medications. For additional information please reach out to NH Healthy Families at 866-769-3085, Monday through Friday 8 a.m. to 5 p.m.
Please note: On 7/8/2019, the NH Healthy Families Pharmacy network is changing. Walgreens and its subsidiaries will no longer be participating providers. Locations in Berlin, Colebrook and Lancaster, and Manchester (Valley Street) will remain in network. To avoid a break in treatment, members should move their medicines to a new pharmacy by 7/8/2019. You can do this by any ONE of the following:
- Call or go to the new pharmacy to ask for the medicine to be transferred.
- Ask your doctor to call or send your prescriptions to the new pharmacy.
- Bring a written prescription to the new pharmacy.
Members and providers can search for other pharmacies on our website by using the Find-a-Doctor tool. Go to NHhealthyfamilies.com and click on "Find a Doctor". Next, click on "Start Provider Search". They can also go directly to the tool by typing providersearch.nhhealthyfamilies.com.
UPDATE: The Walgreens location in Wolfeboro, NH has been added to the pharmacynetwork as of 9/25/2020
We are here to help. If members have questions, call Member Services at 1-866-769-3085 or TDD/TTY at 1-855-742-0123.
Prior Auth Criteria
Envolve Pharmacy Solutions, NH Healthy Families' Pharmacy Benefit Manager, processes pharmacy claims for self-administered (i.e. oral, self-injectable, topical, ophthalmic) drugs. For self-administered medications, use the medication request form below
- Medication Prior Authorization form (PDF)
- Behavioral Health Prior Authorization Form for Community Mental Health Center Providers (PDF)
To complete this form electronically please visit covermymeds.com
Pharmacy Help Desk:
Monday - Friday 8:00 am - 9:00 pm EST
Saturday 9:30 am EST - 6:00 pm EST
Specialty Medication Requests
Specialty medication requests will go to NH Healthy Families. To submit a request for medications that will be administered by a provider (i.e. specialty, home health, outpatient, injectable or infusible medications), use the form below. If you can’t find the specialty drug you are looking for, click here.