Group Health's drug formulary is a list of medications covered by your health plan.
Individual & Family, and Small Employer Group Plans
Information about prescription drug plans and a list of medications available to members in our individual and family plans, or in small employer group (1-50 employees) plans.
Medicare Advantage Plans
List of drugs selected by Group Health Cooperative and Group Health Options, Inc. and approved by the Centers for Medicare and Medicaid Services (CMS) that are covered by Group Health's Medicare Advantage prescription drug plans.
Federal Employee Health Benefits Program
Information about prescription drug plans and a list of medications available to employees and retirees in the Federal Employee Health Benefits (FEHB) program.
Large Employer Group Plans
Information about prescription drug plans and a list of medications available to members in our large employer group (51+ employees) plans.
Large Employer Group Plans Formulary Search
You can search drugs by name or therapeutic class to see if they are in our formulary and whether they require a prescription or prior authorization.
Search by Medication Name
Please enter the name of the drug you are searching for without using special characters such as *, %, or &.
Search by Therapeutic Class
Prior Authorization and Nonformulary Drug Exception Requests
You or your doctor can request coverage for prior authorization drugs or nonformulary drugs. Your request will be reviewed based on our coverage criteria or medical necessity. If we approve the request, you will pay a cost share determined by your member contract. If we do not approve the request, you may still choose to get the medication and pay full price. For more information, see About Our Drug Formulary.
Preventive Medications and Preferred Contraceptives
Most plans cover Affordable Care Act (ACA) requirements for preventive care medicines and contraceptives in full. Please consult your Benefit Booklet under "Preventive Services" or call Customer Service if you have questions about your coverage for these drugs.
Specialty Medications List and Preferred Pharmacies
Some drugs are limited to either Group Health Specialty Medication Pharmacy or BriovaRx Specialty Medication Pharmacy. Limitations only apply to the pharmacy benefit, not the medical benefit. Limitations do not apply to Medicare.