Formulary

A formulary (or drug list) is a list of prescription drugs (opens in new tab) covered by an insurance plan’s benefits.

Check with your health insurance company before filling a new prescription to make sure your new medication is included on the formulary and covered by your plan. If your health insurance company doesn’t cover a certain medication that you need, check in with your doctor about your options. They’ll be able to help you find an alternative or explore whether your insurer will grant an exception.

Formularies usually include generic and brand-name drugs that are classified in different tiers (opens in new tab). Your cost sharing (copays (opens in new tab) vs. coinsurance (opens in new tab) vs. paying the full cost out-of-pocket) will vary depending on the drug type and tier. Check out your Schedule of Benefits (opens in new tab) (or call your insurance company) if you have questions.