Formulary

by David Bynon, last updated

What is a Drug Formulary?

A formulary is a list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. This list is also called a drug list. Medications not on a plan’s formulary are generally not covered. A formulary applies to Medicare Advantage Prescription Drug Plans (MA-PD) and stand-alone Medicare Part D plans.

In some cases, coverage restrictions may apply. Coverage restrictions, or formulary restrictions, are placed on certain drugs to limit their use. Coverage restrictions include prior authorization, quantity limits, and step therapy.

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