What is covered?
A formulary is the list of drugs covered by Neighborhood. We have different formularies for different plans.
The Medicaid formulary is for members enrolled in Neighborhood ACCESS / RIte Care, Neighborhood Trust / Rhody Health Partners, or Neighborhood UNITY / Rhody Health Options (Medicaid only).
UNITY/RHO Formulary (for Dually Eligible Members)
The over-the-counter (OTC) formulary is for members with Medicaid and Medicare coverage enrolled in Neighborhood UNITY / Rhody Health Options.
UNITY / RHO - OTC Formulary
The Exchange formulary is for members enrolled in Neighborhood INNOVATION, ECONOMY, COMMUNITY, VALUE, PLUS, PRINCIPAL, STANDARD, PARTNER, CHOICE, PREMIER, or PRIME plans.
Exchange Formulary - 2017
Exchange Formulary - 2016
Exchange Formulary - 2015
The Medicare-Medicaid formulary is for members enrolled in Neighborhood INTEGRITY (Medicare-Medicaid Plan).
NEW! Pharmacy member portal
Neighborhood now has a pharmacy portal where members can:
- View claims information based on your pharmacy benefit
- Find the location of an in-network pharmacy
- View common drug information such as interactions, side effects and substitutes
Sign in to the portal today! I have a:
Medicaid managed care plan
To initiate the exceptions process for non-covered medications, please fill in this form and submit it to your doctor.
24-hour pharmacies in Neighborhood's network
Neighborhood pays for many over-the-counter (OTC) products like Motrin, Claritin, Robitussin, hydrocortisone cream, and Tylenol. These are drugs and other items that you can find on the shelf and buy without a prescription.
Neighborhood members can get many OTC products at no cost:
- You need a prescription from your doctor
- Supplies are limited to 30 days per refill
Over-the-counter medicines can be safe and helpful when used correctly. They should not replace regular visits with your doctor. Remember, it is best to work with your primary care doctor to decide the treatment that is right for you and your family.
How to get your medicine
- Bring the Neighborhood identification (ID) card of the family member getting a prescription.
- Bring the prescription from the doctor.
- Ask the pharmacist any questions you have about the medicine.
- If you have any problems at the pharmacy getting the medicine, call Neighborhood Member Services at 1-800-459-6019 (TTY 711).
For more information call Neighborhood Member Services at 1-800-459-6019 (TTY 711).