Pharmacy Resources

Trillium Community Health Plan (Trillium) is committed to providing appropriate, high-quality, and cost-effective drug therapy to all Trillium members. Trillium covers prescription medications and certain over-the-counter medications with a written order from a Trillium provider. The pharmacy program does not cover all medications. Some medications may require prior authorization and some may have limitations. Other medically necessary pharmacy services are covered as well.

• OHP Pharmacy PA form (PDF) 
• OHP Non-Formulary Review Request Form (PDF)
• Pharmacy Lock-In Referral Form (PDF)
• Prior Authorizations and Appeals Guide (PDF)
• Trillium Preferred Drug List (PDL) List of Covered Drugs for 2020 - Oregon Health Plan (PDF)
• Trillium Preferred Drug List Alternatives (PDF) revised 8/1/2019
• Prior Authorization Forms for Specialty Drugs