Formulary

A formulary is a list of drugs selected by FHCP in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. FHCP will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a FHCP network pharmacy, and other plan rules are followed.

Please click here or the button below to view our Medicare Formulary. This formulary is effective January 1, 2010. In addition, please read the important 60 Day Notice of Formulary Changes as they are posted below.

Medicare Formulary

Are there any restrictions on my coverage?

Some covered drugs may have additonal requirements or limits on coverage. These requirements can limits may include:

Prior Authorization:

FHCP requires you or your physician to get prior authrization for certain drugs. This means that you will need to get approval from FHCP before you fill your prescriptions. If you don't get approval, FHCP may not cover the drug. For those drugs that indicate "Prior Auth Required" in the formulary, please click here to view FHCP's Prior Authorization Criteria.

Quantity Limits:

For certain drugs, FHCP limits the amount of the drug that FHCP will cover. For those drugs that indicate "Quantity Limits Apply" in the formulary, please click here to view the FHCP's Quantity Limits criteria. Last updated August 13, 2009.

Step Therapy:

In some cases, FHCP requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, FHCP may not cover drug B unless you try Drug A first. If Drug A does not work for you, FHCP will then cover Drug B. For those drugs that indicate "Step Therapy Applies" in the formulary, please click here to view FHCP's Step Therapy criteria. Last updated August 13, 2009.

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