Formularies and Notice of Formulary Updates
Notice of Formulary Updates
We may remove drugs from the formulary, add prior authorization, quantity limits
and/or step therapy restrictions on a drug, and/or move a drug to a higher cost-sharing
tier during the plan year. If the change affects a drug you take, we will notify
you at least 60 days before the change is effective. However, if the U.S. Food and Drug Administration
(FDA) deems a drug on our formulary to be unsafe or if the drug's manufacturer removes
a drug from the market, we may immediately remove the drug from the formulary and
notify all affected members as soon as possible.
Our Formulary and Formulary Alternatives
Our formulary is the list of prescription drugs we cover. You can view and/or print
the Comprehensive Formulary (complete list of covered drugs) by clicking the Comprehensive Formulary
link shown above. When you search our formulary for a drug using the Drug Search
Tool on our website, the results will let you know whether there are formulary alternatives
such as lower-cost generic or brand drugs. If your drug is not covered, we provide
a “formulary alternative" link that lets you know whether an alternative drug is covered by our plan.
We include formulary alternatives in the
Drug Search Tool to help you and your prescribing doctor determine the proper
course of action when a drug you take is not covered by your plan. That is, whether
to request an exception or simply write a new prescription for a formulary alternative.
To help your doctor decide on a formulary alternative, please print your plan’s
comprehensive formulary and take it with you when you visit your doctor. Remember,
by switching to an alternative generic or brand-name drug included on our formulary,
you can avoid paying full cost for a non-formulary drug.
For the most recent list of drugs please contact Customer Care toll-free at 1-866-235-5660, 24 hours a day, 7 days a week.
TTY users call 1-866-236-1069 or use the Comprehensive Formularies and Formulary Updates links above.