Using the PriorityHMO plan Approved Drug List
An approved drug list, also called a formulary, is a list of drugs that your plan will pay for. A committee of local doctors and pharmacists as well as Priority Health staff reviews research to find out which drugs are proven to work. Based on this research, they then add or remove drugs from the list several times a year.
Each Priority Health plan that includes prescription coverage has its own approved drug list. To see which drugs are on your plan's list, use the online Approved Drug List tool.
Drugs not on the list
If a drug is not on the approved drugs list for your Priority Health plan, you might have to pay the full price for that drug instead of just a copayment. Some plans also have a "non-preferred" drug copayment that's higher than the preferred brand-name drug copayment. Talk to your primary care physician (PCP) or other primary health care provider. He or she usually can prescribe a drug that is on the list.
You can ask us to make an exception
If your doctor wants you to have a drug that's not on the PriorityHMOSM formulary, you and your doctor can ask us to make an exception to the formulary. Learn how.