ONECare Drug Formulary

A formulary is a list of all the drugs that are covered for a specific insurance plan. Generally, drugs listed in the formulary are covered as long as the drug is medically necessary, the prescription is filled through a network pharmacy or network mail order facility (when applicable), and other coverage rules are followed. For some drugs, there are additional requirements or limits to coverage.

The drugs on formulary are selected by the drug plan and health professionals. The formulary drugs are then verified by a Pharmacy and Therapeutics Committee, consisting of independent physicians and pharmacists.

Not all drugs are included on the plan formulary. In some cases, drugs are excluded from benefit coverage. In other instances, a combination of clinical and economic criteria were used in making the determination not to include a particular drug.

• ONECare Drug Formulary

Online Tools:

• Utilization Management
• Medication Therapy Management
• Pharmacy Prior Authorization form