Search our Approved Drug Lists (ADLs) to understand pharmacy benefit coverage information by plan, including coverage for a specific drug and utilization management rules like prior authorization requirements, step therapy requirements, age limits and/or quantity limits.
After you've reviewed coverage and criteria, learn how to submit an authorization request.
How do we decide which drugs to cover on our formularies?
We take a multi-faceted approach to safeguarding the safety and efficacy of the drugs/treatments we cover.
- Our Pharmacy & Therapeutics Committee carefully reviews drugs to determine whether they should be included on our formularies
- Each decision is guided by clinically-proven, evidence based standards to ensure medications/treatments are safe and effective
- We also incorporate a Drug utilization review program to support quality care and assure drugs and treatments are used appropriately and deliver the best possible outcomes for members
For more information, including the coverage determination process for our Medicaid plan, visit our formulary updates page.