Pharmacy and prescription drugs
Your benefits include a wide range of prescription drugs. We work with Express Scripts (ESI) to provide these benefits.
To find a pharmacy near you, use the ESI pharmacy locator tool.
Copays are a set dollar amount you pay for a covered service, like getting a prescription filled. This is also known as cost sharing — the member shares the cost of some services. Some CHIP members have pharmacy copays.
You don’t have pharmacy copays. If you have both Medicare and Medicaid, contact your Medicare Part D plan to learn more about your pharmacy benefits.
You don’t have pharmacy copays.
Drug coverage information
Texas Vendor Drug Program (VDP) Formulary
Your or your child’s doctor chooses drugs from the Texas Vendor Drug Program (VDP) formulary. The formulary is a list of all brand-name and generic drugs available in your plan. You can use the searchable formulary to search for drugs by name or type (class).
Some medicines need a preapproval, or an OK, from us before your doctor can prescribe them. For these medicines, your doctor must submit a preapproval request before you can fill your prescription.
When there is a generic drug available on the VDP list, it will usually be covered in place of the brand-name drug. Generic drugs are equal to brand-name drugs as approved by the Food and Drug Administration (FDA). If your prescription says you need the brand-name drug, we will cover the brand-name drug instead of giving you a generic.
Don’t see it listed?
If you need to take a drug not listed in the formulary, you may request an exception at firstname.lastname@example.org. You’ll be asked to supply a reason why it should be covered, such as an allergy to a drug, etc.
You can contact Member Services to have a hard copy of the formulary mailed to you at no cost.
Preferred Drug List (PDL)
For Medicaid members, the Preferred Drug List (PDL) shows which drugs the VDP recommends that your doctor try first.
Preferred Drug List
Drug interactions and side effects
Learn more about drug interactions or side effects on the Express Scripts Drug Information page.
Express Scripts (ESI) forms
If you had to pay for a medicine that is covered under your plan, you may submit a request for reimbursement form.
- ESI Online Registration Instructions – English
- ESI Online Registration Instructions – Spanish
- Walmart Rx Mail Order Form – English
- Walmart Rx Mail Order Form – Spanish