Pending changes to the approved drug list
From time to time, we add or remove drugs from the approved drug list (formulary). We also may change their tier, which determines how much you pay for them. We make these changes based on the scientific evidence we have of their value in helping people get well and stay healthy.
If you are taking a drug that is being removed
If we remove drugs from the formulary during the year, we'll notify you of the change at least 60 days before the date that the change becomes effective. The exceptions to this 60-day notice are when the FDA decides a drug is not safe, or if a drug manufacturer removes the drug from the market.
You may ask Priority Health to make an exception for you so you can continue taking a drug that's removed from the formulary. We must make a decision within 72 hours of your request. Contact Customer Service to make these requests.
Learn more about asking for an exception.
Current and pending changes to the 2017 approved drug list
- Jump down to Changes to/removals from the approved drug list
- ALL CAPS = Brand names
- lower case = generic names
- B/D = Coverage varies under Medicare Part B (hospitalization) vs. Part D (prescription) benefits
- FF = "Free first fill" drug will be provided at zero cost-sharing the first time you fill it
- HI = Home infusion drug
- LA = Limited availability (available only at certain pharmacies)
- PA = Prior authorization from Priority Health is needed
- QL = Quantity limits apply
- ST = Step therapy (trying other drugs first) is required
Additions to approved drug list
|Additions effective January 1, 2017|
|No changes yet this year|
|No changes yet in 2017|