Florida Health Insurance Definitions

Florida Health Insurance Terms:
Define: "Drug Formulary"

What is "Drug Formulary mean?": This is a listing of prescription medications which are approved for use and /or coverage by a Health Plan. These drugs will be dispensed through participating pharmacies to a covered person. The list is subject to periodic review and modification by the Health Plan.

The Blue Shield Drug Formulary is a comprehensive list of preferred generic and brand-name drugs covered under your outpatient prescription drug benefit subject to applicable limits and conditions. You will need to check your Evidence of Coverage (EOC) to determine if the formulary applies to your plan.

Drug formularys are subject to change. You can review the most updated drug formulary information online. If a drug is listed in the formulary, that does not guarantee that it will be prescribed by your physician.

Carriers use medical literature to verify that the formulary drugs chosen are clinically effective and safe. Frequently, several drugs work equally well for a medical condition. The Committee also reviews and updates the formulary quarterly to assist physicians in prescribing medically appropriate and cost-effective medications.

Before prescribing your drug, your physician should consult your insurance Drug Formulary. We recommend that you bring your copy when you visit your doctor so that together you can make decisions about covered medications and alternative medication before he or she writes the prescription. If your doctor prescribes a brand-name drug not listed in the formulary, consider asking whether a formulary drug would be just as effective.

More on Drug Formulary: California Drug Formulary


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