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Formulary FAQs

Knowing which medications are covered by your health insurance, as well as how they are covered, will go a long way in helping you maximize your benefits and save you money.
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Where Can I Get a Copy of My Drug Formulary?

When you coverage beings, you can go to your health insurance plan’s website and view your formulary there. Insurers have a requirement to make this information available during open enrollment as well, so you can…
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Can I Go to My Regular Pharmacy to get my Medication?

Each health plan allows you to get your medications from different approved pharmacies called in-network pharmacies. To find out what pharmacies are considered in-network, you can call your insurance company using the number on the…
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Understanding Drug Tiers

One of the biggest healthcare barriers patients hit can be navigating the details of their prescription drug coverage options. If you know that you’ll need prescription drug coverage, it is important to research and choose…
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Specialty Pharmacies: What Gives?

If you have a chronic, rare or long-term illness that requires medication, you may be required to have certain prescriptions filled by a specific pharmacy network or a mail-order prescription program.
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Save Money Through Prior-Authorizations

Your health plan may require you or your medical provider to get a prior authorization or pre-certification before you receive some services.
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Drug Formulary Vocabulary

Researching your drug formulary can be overwhelming. To make things easier, we’ve put together a drug formulary vocabulary list. Use the information below to help learn about your formulary.
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What is a Drug Formulary?

The formulary shows each covered medication’s place within a number of tiers or categories defined as part of your plan’s pharmacy benefits. The actual number and name of the tiers varies by health plan. Each…
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Are All Drug Formularies the Same?

When crafting a drug formulary, every individual health insurance provider will use its own committee of pharmacists and physicians to determine what drugs are covered and how much they will cost. This variety leads to…
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Can My Drug Formulary Change?

Due to the shifting nature of the pharmaceutical world, formularies change often. As new drugs are approved and more information about new uses for current drugs becomes available, pharmacy and therapeutic committees meet regularly to…
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