As a new or continuing member in our plan, you may be taking drugs that are
not on our formulary. Or you may be taking a drug that is on our formulary
but your ability to get it is limited. For example, you may need a prior
authorization from us before you can fill your prescription.
You should talk to your doctor to decide if you should switch to an
appropriate drug that we cover or request a formulary exception so that we
will cover the drug you take. While you talk to your doctor to determine
the right course of action for you, we may cover your drug in certain cases
during the first 90 days you are a member of our plan.
For each of your drugs that is not on our formulary or if your ability to
get your drugs is limited, we will cover a temporary 30-day supply (unless
you have a prescription written for fewer days) when you go to a network
pharmacy. After your first 30-day supply, we will not pay for these drugs,
even if you have been a member of the plan less than 90 days.
Once it has been identified that you need an exception for a drug that is
not on the formulary, Member Services will help you with the next steps to
request an exception. For more detailed information about your CHRISTUS
Health Plan prescription drug coverage, please review your plan
forms and documents
Have another question you don’t see here?
or call member services at 1-844-282-3025 and we’ll help you find
what you need.
Consumer Advisory Board
Members of CHRISTUS Health Plan have the opportunity to share feedback with
us! If you would like to be a part of the CHRISTUS Health Plan New Mexico
Member Advisory Board, please let us know. You can tell us you are
interested by calling Member Services at 1-844-282-3025.
To participate in the Member Advisory Board, you must be:
A current enrollee of a health plan offered in New Mexico;
An employee of a group that subscribes to the health plan; or
A representative of a consumer organization that represents the
interests of health care consumers. No member of the health plan’s
consumer advisory board shall be an employee of the health plan or its
affiliates, or an immediate family member of a health plan employee.
The Member Advisory Board meets quarterly and serves to advise the health
plan about general operations from the member perspective. We will review
the Member Advisory Board recommendations at the health plan Quality
Improvement Committee. After review, the CHRISTUS Health Plan Chief
Executive Officer will respond to the Member Advisory Board regarding the