Formulary Information

WithMe Health’s formulary (list of covered drugs) is developed & maintained by a Pharmacy & Therapeutics (P&T) Committee. The P&T Committee is made of practicing pharmacists and physicians that have a wide variety of specialties. The formulary is reviewed and updated as new drugs enter the marketplace or when new drug information becomes available. The Committee bases their decision to place a drug on the formulary on the following items:

  • safe use of the medication
  • clinical efficacy of the medication
  • therapeutic need

Cost is considered only after these factors are taken into account. Following the formulary is important for improving quality of care and managing health care costs. Generic drugs are covered on the formulary and are a way to help control your out of pocket costs. You should consult with your prescriber to determine if a generic drug is right for you. Some plans require you to use generic drugs when available.

PLEASE NOTE: The list(s) below may be subject to change. Not all drugs listed are covered by all prescription-drug benefit programs. For specific questions about your coverage, including your cost share, less expensive alternatives, as well as if you have a mandatory mail order benefit, please call the WithMe Health Guide Team at 1-866-840-1877 or refer to your Summary Plan Document (SPD).