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Pharmacy Program

At Trillium, our goal is to offer the right drug coverage to our members. We work with doctors and pharmacists to make sure we offer drugs used to treat many conditions and illnesses.

Trillium covers prescription and some over the counter (OTC) drugs when they are ordered by a licensed prescriber. The pharmacy program does not cover all drugs. Some drugs need our prior approval. Some have a limit on the amount of drug that can be given.

The Trillium preferred drug list (PDF) has a large number of brand name and generic drugs on it. Trillium asks that doctors prescribe medication from the Trillium preferred drug list for their patients who are members of Trillium. Some drugs will need your doctor to submit a prior approval request before the medication can be given to you at the pharmacy. These drugs are on the prior approval list.

Generic Drugs
Generic drugs work the same as brand name drugs. When there is a generic drug available, your doctor will need to ask for a prior approval for the brand name drug. We will review the prior authorization and cover the brand name drug if there is a medical reason you need the brand name drug.

Specialty Drugs
Retail pharmacies do not have specialty drugs. You can get these drugs from our specialty pharmacy, AcariaHealth. Your doctor may need to ask for a prior approval for you to receive a specialty drug.

Over-the-Counter Medications
Trillium will pay for over the counter drugs that are on the preferred drug list. To be covered, your doctor will need to write you a prescription for the drug.

Vaccine Coverage
Trillium has a minimum age limit of 19 for vaccines covered by the pharmacy benefit. Vaccines for members aged 18 years and younger are covered by Vaccines For Children (VFC). For more information on vaccine coverage and to find a VFC provider go to Trillium's Vaccine Coverage webpage.

72-Hour Emergency Supply Policy
If you have an urgent need for a drug, your doctor can ask Trillium for an urgent preapproval. Trillium will look at these requests within 24 hours. If we cannot look at the request in time, Trillium will let the pharmacy give you the drug for three days.

Mail Order Program
If you are taking a drug to treat a long-term medical condition or illness, you may be able to get a 90-day supply of your drug by mail.To learn more, visit these webpages:

Helpful Resources
Pharmacy Forms