Marketplace Pharmacy Benefits

Community is committed to providing you with pharmacy benefits to give you clarity, guidance, and peace of mind regarding prescriptions and improving your health. Here are the directions for how to find a pharmacy provider:

Determine your financial responsibility for a drug based on your pharmacy benefit.

Please review the Pharmacy Benefit Schedule in our pharmacy handbook.

Initiate the exceptions process.

To request an exception, please contact Navitus Health Solutions toll-free at 1.866.333.2757.

To order a mail-order prescription.

Community Health Choice uses the online Pharmacy Postal Prescription Services (PPS) to fulfill mail-order prescriptions. Please follow the steps below to order your medication via mail:

Click here to go to the Pharmacy Postal Prescription Services (PPS) website.
To order a refill for an existing mail-order prescription, please click sign in.

Enter your email address and password where indicated, then click the blue “Sign-In” button.

To create a new PPS account, please click create an account.
Enter your email address where indicated, then press the blue “Send Verification Code” button.

Enter the verification code that was sent to your email address, then press the blue “Submit” button.

Follow the on-screen instructions for adding your personal and prescription information.
If you have problems with your online PPS account, please contact the PPS Customer Service Center at 1.800.552.6694.

To find the location of an in-network pharmacy and/or conduct a pharmacy proximity search based on your ZIP code.

Step 1:

Go to https://www.communityhealthchoice.org/ and select “Find a Doctor.”
Click “Next” at the bottom right to get started.

Step 2:

Select the Marketplace plan you are enrolled in. Here are the two different plans:

PREMIER PLANS – BROADEST NETWORK
Our Premier plans have the broadest network of high-quality Providers across Southeast Texas that are committed to delivering a high standard of care.

SELECT PLANS – LIMITED NETWORK
With a smaller network of high-quality providers, our Select Plans allow us to pass on lower premiums and out-of-pocket costs to our Members without sacrificing quality of care. The Select Plans are available only to Harris County residents.

Once you have selected the plan you are enrolled in, click “Next.”

Step 3:

Validate your ZIP code or address for pharmacies that are near you and click “Validate Address.” Click “Next.” (Example: 77054)

Step 4:

Click “Pharmacies” and “Search.”

Step 5:

The search results will show you the pharmacy closest to you.

Step 6:

Use the drop-down menu to select proximity (5 to 75 miles) and click the “Search” button.

Determine the availability of generic substitutes.

To determine the availability of generic substitutes, please visit your appropriate formulary: Formulary – Premier or Formulary – Select

Press “CTRL + F” simultaneously to open the search bar.

Enter the name of your prescription drug into the search bar, and then press “Enter.”

Generic drugs will appear in small letters in the drug chart.

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Member Resources Overview

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For Marketplace Members

Why Choose Community?

As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, Community is always working life forward for you and your family.

“Community Health Choice is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.”
– Cecily
Member of Community Health Choice