Real answers for your healthcare questions
What is a prescription drug formulary?
Answer
A formulary is the list of prescription drugs a health plan covers. The list often groups medications into tiers that determine how much you pay.
What to Know
A lower tier may contain lower cost generic or preferred medications, while higher tiers can include non preferred or specialty drugs with larger copays or coinsurance. Formularies can also include restrictions such as prior authorization, step therapy, or quantity limits.
What to Do Next
Check the formulary by the exact medication name and dosage before choosing a plan. Review it again each year because covered drugs, tiers, and restrictions can change.
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