Does Community Health Plan use a preferred drug list (formulary)?
Yes, Community Health Plan uses what is called a formulary system. This means it uses a certain list of covered drugs (formulary). The Community Health Plan Pharmacy and Therapeutics Committee, composed of providers and pharmacists, develops this formulary. The committee uses medical studies and research to choose FDA-approved drugs based on safety, effectiveness, and value. Sometimes an exception may be made for a drug not on the formulary, if your provider believes it would be more beneficial for you. See below for the procedure to follow. Please note: If your medical plan does not cover a specific medical condition, then a drug for that condition will not be approved. Please refer to your health program member book for these conditions.
