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Category Archives: Drug Formulary Lists

Understanding Drug Tiers

In this article you will learn that 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 a plan that covers your medication. Under a healthcare plan, the list of covered prescription drugs is called a formulary. The formulary is usually divided into tiers or levels of coverage based on the type or usage of the medication. Each tier will have a defined out-of-pocket cost that the patient must pay before receiving the drug. During…

Specialty Pharmacies: What Gives?

In this article, you will learn 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.

Save Money Through Prior-Authorizations

In this article you will learn that your health plan may require you or your medical provider to get a prior authorization or pre-certification before you receive some services.

Drug Formulary Vocabulary

This article suggests that 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.

What is a Drug Formulary?

This article explains that 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 tier represents a different amount you will have to pay for the drug as part of your out-of-pocket expenses.

Where Can I Get a Copy of My Drug Formulary?

In this article you will learn that when your coverage begins, 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 also view a copy during your plan decision process.

Are All Drug Formularies the Same?

This article discusses 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 each health provider’s drug formulary being unique.

Can I Go to My Regular Pharmacy to get my Medication?

This article explains that 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 back of your card or visit your insurer’s website.

Can My Drug Formulary Change?

This article explains that 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 review their drug formularies and make adjustments.

Know Your Drug Formulary Restrictions: Quantity Limits

This article explains that most drug formularies have restrictions and limits to certain medications. This is done to encourage physicians to use medications appropriately and save money for both you and your insurance provider.