Drugs Covered

Which drugs are covered by my plan?

Looking for Medicare formularies


Plan formularies

You can see the list of drugs covered by your EmblemHealth plan below. This drug list is also known as a formulary.

  • 2020 Essential Plan Formulary: The list of drugs we cover under the Essential Plan for New York State of Health members. It is up to date as of January 1, 2020.

  • 2020 Qualified Health Plan Formulary: The list of drugs we cover under the Qualified Health Plan for New York State of Health members. It is up to date as of January 1, 2020.

  • 2020 Large Group Formulary: This is a list of the most commonly prescribed preferred drugs for members with the Large Group Formulary (over 100 eligible).

  • 2020 Small Group Formulary: This is a list of the most commonly prescribed preferred drugs for members with the Small Group Formulary (Effective January 1, 2020).

  • 2020 Child Health Plus Formulary: This is a list of the most commonly prescribed preferred drugs for members with the Child Health Plus Formulary (Effective January 1, 2020).

YOUR MEDICATION

Delivery and Refills

Find out how to set up home delivery or a get a prescription refill.

MTM PROGRAM

Medication Therapy Management

Find out if you qualify for this service, which is free for EmblemHealth Medicare plan members with Part D prescription drug coverage.

KNOW YOUR RIGHTS

Grievances and Appeals

Find out how to file a grievance or an appeal, request coverage decisions and determinations, and more.

If you are not sure which formulary your plan uses or have any other questions, call your employer’s benefit administrator or EmblemHealth Customer Service at the number on your member ID card.

HELP AND SUPPORT

Pharmacy Support

Search your plan formulary, find participating pharmacies, and access forms.

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