Our drug formulary is a list of the drugs that are approved for coverage. When determining which drugs to approve, committee members consider medical literature and studies of each drug's effectiveness, safety, and cost, compared with other drugs in the same category.
Some drugs require prior authorization.
The reason is that a drug may not be appropriate for every patient or may cause side effects. Your doctor should have a current list of drugs requiring prior authorization, but he or she can call our referral number for authorization and information in cases where your doctor feels there are indications for use of a drug that does not meet HMOC's criteria. Save Money With Generic Drugs Many of the drugs on our formulary are generic equivalents to brand name drugs. We limit the patient's drug benefit to a generic version only when the FDA has rated the generic drug therapeutically equivalent to the brand-name product. All generic drugs prescribed through our plan must contain the same active ingredients in the same strength and dosage form as their brand-name equivalents.