Your pharmacy benefit helps pay for prescription medications based on your specific plan. Costs may include a copay, coinsurance or deductible depending on your coverage.

A formulary is a list of covered medications. Drugs are grouped into tiers based on clinical effectiveness, safety and cost value. Lower-tier medications (like generics) usually cost less. The Christ Hospital uses the Alluma Advantage formulary.

The Member Portal gives you tools to:

• Find in-network pharmacies
• Check coverage and estimated costs
• View copays
• Manage and track prescriptions

Getting started is simple:

1. Visit allumaco.com/members
2. Click “Access member portal”
3. Enter your information from your prescription card
4. Create your login credentials
5. Confirm your account

Yes. Medication prices can vary by pharmacy. You can compare options and explore lower-cost alternatives in the Member Portal using the Coverage Check tool before filling your prescription.

Prior authorization is a clinical review required for certain medications before coverage is approved. It ensures the medication is safe, appropriate and aligned with your benefit.

Some medications require review because they:

1. Treat complex conditions
2. Require specific clinical criteria
3. Are typically used after other treatments

1. Your provider submits a request
2. Clinical experts review it using guidelines
3. You and your provider are notified of the decision

You and your provider will receive an explanation. Your provider may:

• Submit an appeal
• Recommend alternative covered medications

Step therapy may require trying a clinically proven medication before moving to an alternative medication. This often helps to manage costs while maintaining quality care. 

Specialty medications treat complex or chronic conditions and often require:

• Special handling or storage
• Ongoing monitoring
• Additional clinical support

Members of The Christ Hospital plan can fill specialty medications through The Christ Hospital Apothecary or Accredo Specialty Pharmacy.

You may receive:

• Personalized pharmacist support
• Care coordination
• Education and side effect management
• Help navigating coverage

Home delivery allows you to receive eligible medications delivered directly to your door through Express Scripts® Pharmacy. 

• Up to a 90-day supply (when eligible)
• Free standard shipping
• 24/7 access to pharmacists
• Automatic refills and reminders

• Log in to the Member Portal
• Request home delivery
• Ask your provider to send a 90-day prescription
• Confirm your shipping details
• Track your order