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Questions About Your Medicines

What medicines are covered by Keystone First Community HealthChoices?

Keystone First Community HealthChoices covers many prescription medicines and some over-the-counter medicines. Talk with your health care provider, your pharmacist, or Participant Services to find out if a medicine is covered. We make changes and add new medicines to the list of covered medicines from time to time.

To get the most current list, go to Find a medicine or call Participant Services. Keystone First CHC must approve some medicines before you can get them. This is called prior authorization. Prior authorization is a way to make sure you get medicines that are proven to work and are right for you.

Are there any limits to the medicines covered by Keystone First CHC?

Yes, the limits are:

  • There are limits to the amount of medicine dispensed at one time.
  • The medicine must be medically necessary.
  • The medicine must be covered under the Pennsylvania Medical Assistance program.

Does Keystone First CHC cover over-the-counter (OTC) medicines?

Yes. Keystone First CHC covers some OTC medicines if you have a prescription. Prescriptions are given only when you have a medical need for them. Some examples of OTC medicines covered by Keystone First CHC are:

  • Cough syrup.
  • Sinus and allergy medicines.
  • Pain medicine, such as acetaminophen, naproxen, and ibuprofen.
  • Heartburn medicine, such as antacids, cimetidine, and ranitidine.
  • Prenatal vitamins (vitamins for when you are pregnant).

Do all pharmacies accept Keystone First CHC?

Most pharmacies in your area accept Keystone First CHC. Ask your pharmacist to see whether it is part of the Keystone First CHC pharmacy network. Or you can call Participant Services to get a list of the pharmacies in your area that accept Keystone First CHC *.

There could be a co-pay for some of your medicines.