Denver Health Medical Plan Pharmacy

We can answer your questions about pharmacy forms and authorizations. Call the Denver Health Medical Plan Pharmacy Department at 303-602-2070.

Formularies and Pharmacy Authorizations*

Formularies and CGM

DHHA Employer Plans Formulary & Pharmacy Management
Medicaid and CHP+ Formulary/Drug List
Exchange/CO Option Formulary & Pharmacy Management
Medicare Choice Comprehensive Formulary
Medicare Select Comprehensive Formulary
Continuous Glucose Monitor Tip Sheet

Pharmacy Prior Auth Forms

Pharmacy Prior Authorization Request Form
Medicare Prescription Drug Coverage Determination Request Form

Prior Authorization Criteria

DHHA Employer Plans Prior Authorization Criteria
Exchange/CO Option Prior Authorization Criteria
Medicaid and CHP+ Prior Authorization Criteria
Medicare Prior Authorization Criteria
Medicare Step Therapy Criteria

*Beginning October 1, 2023, Elevate Medicare Advantage and Elevate Exchange/Colorado Option Pharmacy Prior Authorizations will be reviewed by Medimpact. They can be reached at 1-800-788-2949.

Submit an Online Pharmacy Prior Authorization Request

You must first complete a Pharmacy Prior Authorization Request form and save it to your computer before uploading the file.

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Photo of pharmacist with member.

Pharmacies

Pharmacy Locations

Prescriptions can be filled at any Denver Health Pharmacy, as long as they are written by a Denver Health provider. Denver Health Pharmacies will give members the lowest prescription costs. 

Most prescriptions can also be filled at any National Network Pharmacy, such as Birdi™ (formerly MedImpact Direct®), King Soopers, Walgreens, Safeway and most large retail pharmacy chains.

Mail Order Pharmacy

Denver Health Pharmacy by Mail 
(Available to Medicare, DHHA Employer Plans, Exchange/CO Option, Medicaid, CHP+ plans)
Birdi™ Mail Order Pharmacy 
(Available to Medicare, DHHA Employer Plans, Exchange/CO Option plans only) 

Providers of Medicare Members:

Request for Redetermination of Medicare Prescription Drug Denial

If Denver Health Medical Plan, Inc., has denied a request for coverage of (or payment for) a prescription drug, members have the right to ask us for a redetermination (appeal) of our decision. The member's prescriber may ask us for an appeal on member's behalf. Members have 60 days from the date of our Notice of Denial of Medicare Prescription Drug Coverage to ask us for a redetermination. The Request for Redetermination of Medicare Prescription Drug Denial Form may be sent to us by mail or fax.

Mail to:
Denver Health Medical Plan, Inc.
Attn: Complaints and Appeals Department
777 Bannock St., MC 6000
Denver, CO 80204

Fax to: 303-602-2078

The member, or their prescriber, may also ask us for an appeal using the Complaint and Appeal Form. Expedited appeal requests can be made by phone to Health Plan Services at 303-602-2111 or toll-free 877-956-2111. TTY users should call 711. Our hours of operation are 8 a.m. – 8 p.m. seven days a week.