Pharmacy Program
Ensuring Access to Safe and Effective Medications
At Trillium Community Health Plan, our goal is to provide the right drug coverage for our members. We work closely with doctors and pharmacists to offer medications that treat a range of conditions and illnesses.
We work with partners who help us provide solutions that meet your needs. Together we help improve your health and make treatments more affordable. We also make sure you have access to important medications and clinical programs.
Clinical Programs
Trillium offers special programs that help you stick to your medications and avoid mistakes. These programs can help you improve your health. We support you in managing long-term conditions. We also make sure you get the right medications at the right time to stay healthy.
Medication Therapy Management (MTM): Our MTM programs help you understand and manage your medications. We work with you to improve your health routine and get the best results from your treatments.
Medication Coverage
We have a large network to give you access to many types of pharmacies. Our network includes retail, mail-order, and specialty pharmacies. This makes it easy for you to get medications that meet your needs.
Trillium covers certain prescription drugs. Trillium also covers over-the-counter (OTC) drugs when prescribed by a Trillium provider. We do not cover all drugs. Some need prior authorization. Some drugs have limits on age, dosage or quantities.
The Preferred Drug List (PDL) is the list of drugs covered by Trillium. Trillium asks that doctors prescribe medications from the Trillium Preferred Drug List. Before you can get some medications, your doctor needs to send a prior authorization request.
- Preferred Drug List (PDF) – A list of covered prescription drugs
- Lista de medicamentos preferidos (PDF) – Las Listas de medicamentos preferidos
- Preferred Drug List (JSON) – A machine-readable list of covered prescription drugs
Your doctor, Trillium or your pharmacy will tell you if a prescription you take is no longer preferred. You may need to switch to a different medication. You can ask your doctor to send a prior authorization request to stay on your current medication. If you get a letter in the mail from Trillium, please read it carefully. Talk to your doctor about it at your next visit or call your doctor’s office. If you try to refill your prescription before your next visit, the pharmacy may tell you that your medication needs prior authorization. We will work with your doctor to make sure you get the medication you need. You will not lose drug coverage. You will keep using the same Medicaid ID.
If you have questions about your prescription, call Trillium Member Services at 1-877-600-5472 (TTY 711).
Generic Drugs
Generic drugs work the same as brand name drugs. Your doctor will need to ask for a prior approval for the brand name drug when a generic drug is available. We will review the prior authorization. If there is a medical reason you need the brand name drug, we will cover the brand name drug.
Specialty Drugs
Retail pharmacies do not have specialty drugs. You can get these drugs from our specialty pharmacy, AcariaHealth. Your doctor may need to ask for a prior approval for you to receive a specialty drug.
Specialty Pharmacy Services
What is a Specialty Medication?
A specialty drug is a prescription drug that needs special handling, administration, or monitoring. These are only ordered through a specialty pharmacy.
What is a Specialty Pharmacy?
A specialty pharmacy provides services and medications for members with chronic, complex or rare conditions. Specialty pharmacies provide medication that is often considered high-touch or high-cost. Specialty pharmacies provide services that are done by highly trained professionals. These services are more extensive than regular retail pharmacies offer. Specialty pharmacy services can include clinical help, such as training on how to take medication.
Access to Specialty Medications
Through our specialty pharmacy services, we offer support for high-cost medications and complex therapies. We make sure you can get the treatments you need with guidance from a dedicated pharmacy team.
Your Specialty Pharmacy is AcariaHealth
AcariaHealth is a national specialty pharmacy. AcariaHealth is dedicated to transforming lives through compassionate care. They focus on helping people with complex medical conditions. AcariaHealth will work with you and your healthcare providers on treatment programs to meet your needs.
Contact AcariaHealth
P: 1-800-511-5144 (TTY 711)
F: 1-877-541-1503
Learn more about AcariaHealth at the AcariaHealth website.
Sometimes, certain medications are not available through AcariaHealth. For example, some medications are only available at other pharmacies in a limited distribution network. In these cases, we will cover your medication through a different specialty pharmacy.
Fill and Receive Your Prescriptions
You can fill your prescriptions at a network pharmacy. You will need to give the pharmacist your prescription and your Trillium ID Card.
To find a pharmacy that is in the Trillium 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. This will generate a list of pharmacies in the Trillium network.
Pharmacy Services
Our pharmacy program takes a personalized, community-focused approach. We help find solutions that meet the needs of our providers and members. This approach enhances care coordination, improves clinical outcomes, and reduces risks. It results in better patient satisfaction and care delivery.
Over-the-Counter (OTC) Medications
Trillium will pay for over-the-counter drugs that are on the Preferred Drug List. To have them covered, your doctor will need to give you a prescription for the medication.
Vaccine Coverage
Trillium has a minimum age limit of 19 for vaccines covered by the pharmacy benefit. Vaccines For Children (VFC) covers vaccines for members aged 18 years and younger. For more information on vaccine coverage and to find a VFC provider go to Trillium's Vaccine Coverage webpage.
72-Hour Emergency Supply Policy
If you have an urgent need for a drug, your doctor can ask Trillium for an urgent pre-approval. Trillium will look at these requests within 24 hours. If we cannot look at the request in time, Trillium will let the pharmacy give you the drug for three days.
Mail Order Program
If you are taking medication for a long-term condition, you may be able to get a 100-day supply of your medication by mail. To learn more, visit these webpages:
Learn More
Get in Touch: For more information, contact us at: 1-877-600-5472.