Rightway

Call Rightway
833-419-8361

with any questions. They are staffed 24/7/365. There are also a set of FAQs available, HERE.

Rightway Mobile App

24/7 access in the palm of your hand.
Click Here to download and learn more.

ID Cards Are Mailed

Rightway ID cards are mailed to new Members. A digital pharmacy ID card will also be available in the Rightway app and desktop portal. View the Rightway Registration and App Guide HERE.

View Rightway Formulary

Click HERE to view the formulary specific to the NY44 Rx plan. If you prefer you can view this information in the Rightway member app, member portal, or just call the Rightway team at 833-419-8361.

Walgreens
Mail Service

Mail service is not required but is a convenient way to receive maintenance medications. View the Getting started with Mail Service flyer HERE.

Attention New NY44 Enrollees

If you are a new enrollee with the NY44 Plan who takes prescription medications regularly, click HERE to learn how to get started with Rightway..

Rightway Formulary Change Effective July 1, 2026

If you are impacted, Rightway will notify you by USPS mail at least 60 days in advance. This will allow time to consult with your prescriber about switching to a formulary alternative option or request a formulary exception for medical necessity. The member communication will include the preferred formulary alternatives as well as options and guidance for the member to work directly with their prescriber. Contact the Rightway pharmacy navigation team for concierge-level service with questions: 833-419-8361.

Pharmacy Benefit FAQs

If you need to contact Capital Rx regarding a prescription drug claim that happened prior to July 1, 2025, please contact Capital Rx customer service at 1-833-772-2779

WATCH: Rightway Train the Trainer Webinar

WATCH: Rightway Member Webinar

KEY POINTS INCLUDE:

Plan Design and Copays

These will remain the same.

Formulary

To search for medications and access prescription drug benefit details specific to the NY44 Rx plan, Members should log into the Rightway member app or portal. Click HERE to go to the Rightway Member portal.

Mail-Order Prescriptions

It will no longer be mandatory to use mail order when filling a prescription for a 90-day supply of maintenance medications. These can be filled at a retail pharmacy or, if you prefer, through mail order.
You can fill your 90-day maintenance medications at any participating pharmacy, including Wegmans and Stony Point.
Rightway will, where possible, automatically transfer any current Optum mail-order prescriptions to the new mail-order vendor, Walgreens. Exceptions will include expired prescriptions, prescriptions without remaining refills, compound medications, and controlled substances.
Non-Maintenance Medication:
Members can keep their prescriptions at their current pharmacy.

Resources

Transition Guide for New Members

Rightway Formulary

Pharmacy Benefits FAQs

Rightway Getting Started Flyer

Rightway Registration and App Guide

Walgreens Mail Service Getting Started

Walgreens Specialty Pharmacy Getting Started

Quantity Limits List

Prior Authorization Form

Prior Authorization and Step Therapy List

HIPAA Privacy Form

Direct Member Reimbursement Form

ACA Preventive List

Specialty Drug List

Important Information:
Wegmans and Stony Point Pharmacy

Members still have the option to use the Wegmans and the Stony Point Pharmacy.

You can still get your 90-day maintenance medication refills at Wegmans retail pharmacy locations. For those living in Rockland County, Stony Point Pharmacy remains available as an alternative option. These pharmacy choices will continue to be available even after NY44 Health Benefits Plan Trust transitions to Rightway.

Pharmacy Benefit FAQs

Outlined below are answers to some questions to help you understand the Rightway pharmacy benefits.

For any additional questions, please contact the Rightway team at 833-419-8361. This phone line above is available 24 hours a day, 7 days a week to answer any questions you may have about your prescription benefit plan.

Q1: Who is Rightway?
Rightway is your pharmacy benefits provider. That means they are the service that covers your prescription medication. Rightway healthcare experts have your specific benefits information and know how to get you the most appropriate prescription medication at the best price. There is never any cost to use our service. Your health guide can:

Explain your coverage and help you find the most affordable option

Discuss your medications and advise on how to manage any possible side effects.

Help with prior authorizations, specialty medications, refills, or mail delivery

Contact your provider’s office to request an alternate medication on your behalf

Connect with a Rightway pharmacist, who can perform a comprehensive medication review and answer your questions
Q2: Will I receive a new ID card?
Q3: What do I do if I need a prescription filled and have not received my ID card?
Q4: How do I replace a lost ID card?
Q5: What information will I receive directly from Rightway?
Q6: What formulary has NY44 Health Benefits Plan Trust selected and where can I find what medications are on it?
Q7: Will there be any change to how GLP-1 drugs are covered?

No. The NY44 Health Benefits Plan Trust only covers GLP-1 drugs approved by the FDA for treatment of type 2 Diabetes. Criteria is in-place to ensure these drugs are only being used for treatment of diabetes. GLP-1 drugs in this category include Ozempic, Mounjaro. GLP-1 drugs approved by the FDA for any other reason, for example weight loss such as Wegovy, Zepbound, and Saxenda are not covered.
Q8: Can I still fill my prescriptions at my preferred pharmacy with Rightway?

Rightway maintains a national network of more than 65,000 pharmacies, including all national chains and most independent pharmacies. To confirm the network status of your preferred pharmacy, please log in to the Member portal or contact the Rightway team at 833-419-8361.
Q9: Where can I find out how much my copays are for my specific plan?
Q10: Is my current (or new) prescription covered by Rightway?

Your coverage for each prescription drug is outlined on our formulary (i.e. preferred drug list). To confirm the coverage status of a medication, including if a prior authorization, step therapy, or quantity limit applies, please consult the formulary specific to your prescription benefit plan by logging into the Rightway member portal. If you have additional questions, call the Rightway team at 833-419-8361.
Q11: How do I know what my out-of-pocket cost (i.e. copay or coinsurance) will be with Rightway?

What you pay for a prescription is determined by how your employer has structured your prescription benefit. Although this information is not outlined in the Rightway formulary, you can access a Summary Plan Document (SPD) or Schedule of Benefits on the NY44 Health Benefits Trust’s website. You can also search for drug prices using the Proactive Drug Search feature in the Rightway member portal.

If you have additional questions, call the Rightway team at 833-419-8361.
Q12: How do I request reimbursement for my pharmacy claim if it did not process through my pharmacy benefit?

If for any reason you were unable to apply your prescription benefit at an in-network pharmacy to fill a prescription, you can make a request for reimbursement by completing our Direct Member Reimbursement (DMR) form and mailing it to the below address, along with the original receipt from the pharmacy (please make a copy for your own records).

RightwayRx
PO Box 996
Attn: Paper Claims
Portland, ME 04104

It is important that you provide us with as much detail as possible so that we can process your claim appropriately for reimbursement. Dependent on your plan’s elections, you may be reimbursed directly for covered prescriptions. Prescriptions filled at out-of-network pharmacies are not covered under your plan.

If you have additional questions, chat with the Rightway team via the Rightway app or call 833-419-8361.
Q13: How do I receive mail-order delivery of my maintenance medication?

As a member of Rightway, you’re eligible to receive your prescriptions from Walgreens Mail Service. You can get started online by registering at WalgreensMailService.com.

You are not required to use mail order and can use any in network pharmacy for a prescription of 90-day maintenance medications.

If you have additional questions, chat with the Rightway team via the Rightway app or call 833-419-8361.
Q14: Can I still order a 90-day supply of medication and pick it up at Wegmans or Stony Point pharmacy?
Q15: How do I check the status of my mail order prescription?
Q16: How do I fill my specialty medication?
If you are prescribed a specialty medication (e.g. multiple sclerosis, hepatitis C, oncology, HIV, and many others), you can quickly and easily order your prescription by following the steps below.

Call Walgreens Specialty Pharmacy at 866-249-5367 to enroll

Have your doctor send us your specialty prescription through e-prescribe

Opt-in via your onboarding text to start tracking your prescription

Please have the following with you:

Prescription member ID card

Prescribing doctor’s name, telephone and fax number

Specialty medication information, including medication name and strength

If you have additional questions, chat with the Rightway team via the Rightway app or call 833-419-8361.
Q17: I currently receive medications through Payer Matrix. How will this be impacted by the change to Rightway?

If you currently receive medications through Payer Matrix, please contact Rightway’s Specialty Pharmacy team at 833-419-8361. The Rightway Specialty Pharmacy team will review your prescription details and help ensure you have continued access to the medications you need. They can explain any changes to your coverage and guide you through next steps.
Q18: How do I access my Rightway member tools and resources?

You can register on the Rightway member portal or our mobile app. Rightway digital resources are available through the desktop and mobile app, creating a seamless healthcare experience for you. Download the Rightway app on the App Store or Google Play or access the Rightway member portal HERE.
Q19: What can I do when I register my account on the member portal and mobile application?
The Rightway portal and mobile app have the following features:

Explain your coverage and help you find the most affordable option

Discuss your medications and advise on how to manage any possible side effects

Help with prior authorizations, specialty medications, refills, or mail delivery

Contact your provider’s office to request an alternate medication on your behalf

Connect with a Rightway pharmacist, who can perform a comprehensive medication review and answer your questions

View your digital Rx ID card
Q20: How do I download the Rightway mobile application?
Q21: What is a Prior Authorization (PA)?

A prior authorization (PA) is a feature of your prescription benefit plan that requires you and your physician to obtain approval before the prescribed medication can be dispensed by a retail or mail order pharmacy. This requirement exists to prevent inappropriate prescribing of certain medications and to ensure the lowest cost alternative is used (subject to medical necessity).

To submit a prior authorization (if required) ask your physician to complete the prior authorization request form and send it with any additional documentation required to Rightway via fax to 888-498-1038.

The Rightway clinical team will notify you and your physician in advance of any declinations and assist you in expediting an alternative therapy.

To determine whether your medication requires a prior authorization, refer to the formulary for your prescription plan. Log into the Rightway member portal or use the mobile app. If you have additional questions, call the Rightway team at 833-419-8361. Click HERE to go to the Rightway Member portal.
Q22: What is step therapy (ST)?

Step therapy (ST) is a feature of your prescription benefit plan that requires you try another medication (usually a generic) before being prescribed the medication designated with step therapy (usually a brand). This requirement exists to prevent inappropriate prescribing of certain medications and to ensure the lowest cost alternative is used. If your physician prescribes, or wants to prescribe, a medication designated with step therapy, please have them call your dedicated Rightway Customer Care team 888-498-1038.

To determine whether your medication requires step therapy, Refer to the formulary for your prescription plan. Log into the Rightway member portal or use the mobile app. If you have additional questions, call the Rightway team at 833-419-8361. Click HERE to go to the Rightway Member portal.
Q23: What is a quantity limit (QL)?

A quantity limit (QL) is a feature of your prescription benefit plan that only allows you to receive up to a maximum dosage or quantity for certain medications (e.g. opioids). Quantity limit requirements exist to ensure safe and effective doses are prescribed and to prevent waste, fraud, and abuse. If you and your physician require a dose or quantity beyond what the quantity limit allows, please submit a prior authorization, including medical justification for the larger dose or quantity.

To determine whether your medication has a quantity limit, refer to the formulary for your prescription plan. Log into the Rightway member portal or use the mobile app. If you have additional questions, call the Rightway team at 833-419-8361. Click HERE to go to the Rightway Member portal.
Q24: How do I authorize a family member or care giver to manage my pharmacy benefits?
Q25: If someone is currently on a Payer Matrix drug will that drug go through Walgreen's Specialty or will Rightway be finding it through a PAP program? What steps does the member need to take?

If a member is currently enrolled in a manufacturer’s Patient Assistance Program, enrolled members will remain in their programs until support for re-enrollment is needed.

Rightway

Call Rightway 833-419-8361

Rightway Mobile App

ID Cards Are Mailed

View Rightway Formulary

Walgreens Mail Service

Attention New NY44 Enrollees

Rightway Formulary Change Effective July 1, 2026

WATCH: Rightway Train the Trainer Webinar

WATCH: Rightway Member Webinar

KEY POINTS INCLUDE:

Resources

Important Information:Wegmans and Stony Point Pharmacy

Members still have the option to use the Wegmans and the Stony Point Pharmacy.

Pharmacy Benefit FAQs

Call Rightway
833-419-8361

Walgreens
Mail Service

Important Information:
Wegmans and Stony Point Pharmacy