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A formulary is a list of covered drugs covered by Physicians Health Choice. The formulary may change during the year. Physicians Health Choice covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.
1. Begin your search by selecting either the Drug Category or Tier from the drop-down menu, or by typing in the name (or first few letters) of the drug. Click OK or Search, depending on the type of search you are conducting.
2. The list of covered drugs would be displayed along with the drug details such as Tier, Category, Class, dosage, Strength and any restrictions.
3. If no records are returned, the drug is not covered or you may have misspelled the drug name.
4. You can perform a new search by starting these steps over.
Tier Descriptions | |
|---|---|
| Need additional assistance? Please call us at 1-866-658-9456 (TTY: 711), October 15, 2011 – March 1, 2012: 8 a.m. – 8 p.m., 7 days a week; and March 2, 2012 – October 14, 2012: 8 a.m. – 8 p.m., Monday – Friday. | |
| Tier 1 | Preferred Generic: Lowest Copay This tier includes lower-cost, commonly-used generic drugs. Use Tier 1 drugs for the lowest out-of-pocket costs. |
| Tier 2 | Non-Preferred Generic: Low Copay This tier includes most generic drugs. Use Tier 2 drugs, instead of Tier 3 or 4, to help reduce your out-of-pocket costs. |
| Tier 3 | Preferred Brand: Medium Copay This tier includes many common brand name drugs, called preferred brands, and some higher-cost generic drugs. Many Tier 3 drugs have lower-cost options in Tier 1 or 2. Ask your doctor if they could work for you. |
| Tier 4 | Non-Preferred Brand: Highest Copay This tier includes non-preferred generic and non-preferred brand drugs. Many Tier 4 drugs have lower-cost options in Tier 1, 2 or 3. Ask your doctor if you can switch to one of these drugs to help reduce your out-of-pocket costs. |
| Tier 5 | Specialty Tier: Coinsurance This tier includes unique and/or very high-cost drugs. You pay a percentage of the total drug cost, called coinsurance. |