Tufts Health RITogether Pharmacy
We want to give you high-quality, cost-effective options for drug therapy. To do that, we work with providers and pharmacists. 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.
Some drugs must meet clinical guidelines before we can cover them. Your provider must ask us for prior approval before we cover one of these drugs.
What drugs are covered?
We use a Preferred Drug List (PDL). To find out if we cover a certain drug, look it up in our PDL. We update the PDL every three months. The PDL applies only to drugs you get at pharmacies. It does not apply to drugs you get at the hospital.
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.
Due to Rhode Island law, all Medicaid members must use generic drugs first. Some brand-name drugs are covered. The state updates this list often. 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. We will review the request. If we do not approve it, you or your authorized caretaker can appeal. See “Your Concerns” in your Member Handbook.
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 a.m. to 6 p.m.
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.
If you have questions, call 866.738.4116 (TTY: 711). We're open Monday through Friday, from 8 a.m. to 6 p.m. We're happy to help.