Varying list of prescription drugs approved by a given health plan for distribution to a covered person through specific pharmacies. See also Formulary.
The list of prescription drugs for which a particular employer or State Medicaid program will pay. Formularies are either "closed," including only certain drugs or "open," including all drugs. Both types of formularies typically impose a cost scale requiring consumers to pay more for certain brands or types of drugs.
A list of specific prescription medicines approved for plan participants. Dispensed for specific conditions and through participating pharmacies under managed care plans.
a complete list drugs available to you as a San Francisco Health Plan Medi-Cal member
a list of drugs an insurer will cover
a list of medications selected to be offered by our drug program, based on safety, efficacy, and cost-effectiveness
a list of medications that are recommended for use
a list of prescribed medications, both name brand products and generic, which the insurance carrier agreed to cover the cost of
a list of prescription medications that a drug plan will pay for
Many defined network plans establish a list of prescription drugs that the plan considers medically appropriate and cost effective. The defined network plan will provide coverage for only those prescription drugs named in the list. However, your doctor may present medical evidence to the insurer to obtain an exception that will allow coverage for a prescription drug not routinely covered by the plan.
L.A. Care uses a drug formulary or list of approved drugs that have been chosen for their safety and effectiveness. Your doctor should normally order drugs from the approved list. The Medi-Cal formulary lists the drugs that are paid for by the Medi-Cal program.
is a listing of medications that consumers may readily access through their health plans. Non-formulary medications may not be accessible or may be accessible only if prior authorization is obtained. Often, the medications on the formulary tend to be the cheapest, rather than the most effective. 27
Each health plan develops its own preferred list of FDA-approved generic and brand-name drugs, called a drug formulary. These drugs generally have the lowest out-of-pocket cost to members. The formulary is chosen by a committee of doctors, pharmacists and other medical experts who consider many cost and quality issues as they make their decisions.
A listing of prescription medications that are preferred for use by the health plan.
A list of pharmaceutical products and dosages deemed by a healthcare organization to the best, most economical treatments. The list varies from one organization to another, and in some healthcare systems, providers are expected to use the listed products. (Also called the Preferred Drug List)
A list of drugs compiled by a government body, third-party insurer or health plan, or another institution that may or may not be dispensed or reimbursed. Some institutions or health plans develop closed (i.e., restricted) formularies where only those drug products listed can be dispensed in that institution or reimbursed by the health plan. Other formularies may have no restrictions (open formularies) or may have limited restrictions such as higher patient co-payments for non-formulary drugs.
The specific list of drugs that a health plan will pay for as part of the benefit package. These drugs are available through the plan or member pharmacies and are frequently reviewed and revised.
The list of prescription drugs for which a state Medicaid program will pay. If a drug is not on the state's formulary, Medicaid will not pay for it.
A list of covered or reimbursable drugs approved for use within a health care system or by clients of a PBM.
A listing of prescription medications which are approved for use and/or coverage by the plan and which will be dispensed through participating pharmacies to a covered person. The list is subject to periodic review and modification by the health plan.
A list of prescription medications that have been approved for use by the health plan. An open formulary allows coverage for non-formulary medications. A closed formulary limits coverage to those drugs in the formulary.
List of preferred pharmaceutical products.
A list of drugs covered by the plan and supplied by participating pharmacies.
A listing of prescription drugs and insulin established by the health plan which includes both Brand Name Prescription Drugs, and Generic Prescription Drugs. This list is subject to periodic review and modification by the health plan. Drugs listed on the formulary are covered under our managed prescription drug plans, with copayments that may vary based on plan design. Certain non-formulary drugs are also covered under some plan designs.