We work with your health care providers and pharmacists to make sure we cover the most important and useful drugs. Together we make sure we cover the most useful drugs for many conditions.
Our plans cover first-time prescriptions and refills. We also cover some over-the-counter (OTC) drugs with a provider’s prescription.
Our pharmacy program does not cover all drugs and prescriptions. Some drugs must meet clinical guidelines before we can cover them. Your provider must ask us for prior approval (PA) before we cover these drugs.
- Preferred Drug List (PDL) - Find out which drugs are covered by your plan
- Drug interaction checker
- Prescription reimbursement standard claim form
What drugs are covered?
We use a Preferred Drug List (PDL). We list all drugs based on their category and drug class, followed by generic or brand drug names. Use the index to find a drug by its generic or brand name. The PDL applies only to drugs you get at pharmacies. It does not apply to drugs you get at the hospital. We update the PDL every month. See the most current PDL or call us at 866-738-4116 (TTY: 711).
2025
- Tufts Health RITogether 2025 PDL | Searchable List
- Tufts Health RITogether 2025 PDL (Spanish)
- Tufts Health RITogether 2025 PDL (Portuguese)
What is the difference between generic and brand-name drugs?
Generic and brand-name drugs have the same active ingredients. Both are safe. They also work the same way to help you feel better.
Rhode Island has a Generic First Program that requires that all members use generic drugs first. Some brand-name drugs are covered. The state updates this list as needed. Most brand-name drugs and some generic drugs require prior approval.
Your provider can ask for prior approval if you and your provider feel a generic drug is not working and that a brand-name drug is medically necessary. One of our clinicians will review the request. If we do not approve the request, you or your authorized representative can appeal the decision. See your Member Handbook to learn more about grievances and appeals.
For more information, call us at 866-738-4116 (TTY: 711).
Where can I fill prescriptions?
Most large-chain and independent pharmacies can fill them. Show your Tufts Health Plan and Rhode Island Medicaid ID cards to the pharmacy staff.
For list of participating pharmacies near you, use our Find a Doctor, Hospital or Pharmacy tool. You can also call us at 866-738-4116 (TTY: 711). We’re open Monday through Friday, from 8 am to 6 pm.
Do I have a copayment?
Some members with extended family planning benefits may have a small prescription copayment. This is a fixed amount you have to pay for a covered service.
Questions?
If you have questions, call 866-738-4116 (TTY: 711). We're open Monday through Friday, from 8 am to 6 pm. We're happy to help.