Pharmacy Benefits Program

Family Health Network has chosen CVS Caremark to provide your pharmacy benefits. The following information will help you understand your benefits. It will also answer many of your questions. 

Always take your Family Health Network ID Card to the pharmacy. You will not have to pay for your prescriptions.

Pharmacy Formulary and Pharmacy Management Procedures

The first section of this document describes the formulary management procedures including, but not limited to, generic medications, exception requests for formulary and non-formulary drugs, quantity limits, step therapy, therapeutic interchange and specialty medications. It is followed by the formulary list of drugs with notations where appropriate. The formulary includes information on restrictions and preferences. Press here to view the Pharmacy Formulary and Pharmacy Management Procedures.

Item Last Updated: 29 September 2017 11:13 CST

 

Over-the-Counter List

Family Health Network covers many over-the counter drugs if you have a doctor’s prescription. See the Over-the-Counter list.

Item Last Updated: 29 September 2017 11:15 CST

 

Quick Reference List

A summary of covered drugs by category is found in the Quick Reference List.

Item Last Updated: 29 September 2017 11:16 CST

 

Pharmacy Locator

Use our easy Pharmacy locator to find a pharmacy near you. 

Attention Members and Visitors: You do not need to log-in to the CVS portal to find the location of an in-network pharmacy or conduct a pharmacy proximity search. 

Item Last Updated: 14 March 2016 10:14 CST

Drug Reference and Interactions

You may want to learn more about your drugs. Use our easy look up Drug Reference and Interactions tool. You can learn about:

  • Drug interactions
  • Side effects and risks of the drugs
  • Generic substitutions available for a brand name drug

Family Health Network requires the use of generic drugs whenever they are available

Attention Members and Visitors: You do not need to log-in to the CVS portal to check potential drug-drug interactions or determine a drug’s common side-effects and risks.

Item Last Updated: 14 March 2016 10:20 CST

Formulary Exception/Prior Authorization

If you (or your representative) or your doctor feel you need a drug not covered, you can ask for a formulary exception. This is called a Formulary Exception/Prior Authorization Request. This can be done in three ways:

Complete the Formulary Exception/Prior Authorization Request online or,
Ask your doctor to submit the Formulary Exception/Prior Authorization form for you or,
Call CVS Caremark at (855) 293-4114 to ask for a Formulary Exception/Prior Authorization

If the drug is not approved, you and your doctor will get a letter explaining the reason for denial

*In order to complete the Formulary Exception/Prior Authorization Request online, an account must be created.

Item Last Updated: 30 November 2016 16:08 CST

 

90 Day Medication List

If your medicine is on the 90-Day Medication List, ask your doctor to give you a 90-day prescription. 
Ask the pharmacist to call or text you a reminder when it is time to refill your prescription.
90 Day Maintenance Medications

Item Last Updated: 14 March 2016 10:20 CST

 

Pharmacy Updates & Notices

Medication Safety Alerts and Recall Notices

Keeping you safe is our first priority. The most up-to-date medication safety alerts and medication recalls can be found here.

Item Last Updated: 26 September 2016 12:46 CST

 

Understanding your drugs are important for good health!

For more information, call:
Family Health Network Member Services (888) 346-4968
CVS Caremark (855) 293-4114

Attention ProvidersBehavioral Health

Important updates about behavioral health services that will impact providers. Effective June 1, 2016, FHN will contract with Behavior Health Specialist directly. Click below for more information

 Provider Notice                                              FAQs        

Member Services

If you have a question about your health plan, please call Member Services.  Hours are 8 a.m. to 5 p.m. Monday through Friday and 9 a.m. to 1 p.m. Saturday.


Si tiene preguntas sobre su plan de salud, por favor llame a la línea de Atención a Miembros Participantes. Horario de 8 a.m. a 5 p.m. de Lunes a Viernes y Sábado de 9 a.m. a 1 p.m.

1-888-FHN-4YOU
(346-4968)
TTY: 711

FLU Season

Flu season begins in October and lasts as late as May. Talk to your doctor about getting a FREE flu shot today.

Click here for more information

Service Area

FHN serves people living in the Chicago area: including Cook, DuPage, Kane, Kankakee, Lake and Will Counties.

Service outside of our Service Area

If you are not in our service area and you need care but it is not an emergency, please call us at 1-888-346-4968 TTY: 711. We will work with you to help you get the care and services you need. When FHN helps to arrange non-emergency services for you outside its service area, we will cover the cost. If you get services outside of our coverage area, we may not pay for those services.
If you are not in our service area and you need emergency care, call 911 or go to the nearest hospital.