Presbyterian

Health Plan, Inc.

Explore

  • Is My Provider in-Network?

    Presbyterian Health Plan members can log into myPRES to determine which providers in Presbyterian’s network of more than 9,000 providers are covered by their plan.

    Find a Doctor.
  • Presbyterian Medical Group Providers

    Presbyterian Medical Group has 600 dedicated physicians and providers in 40 specialties at more than 100 clinics throughout New Mexico – all dedicated to your health and comfort.

    Learn More.
  • What's Happening at Presbyterian

    Find out about the newest staff and the latest technology, and all the other happenings at Presbyterian.

    Learn More.

Group Plan Formularies

 

This page lists important information that your doctor uses when determining the most appropriate course of treatment for you. Formularies include many commonly prescribed medications, both brand name and generic. Check the Formulary List to see if your drug is covered. Prior authorization forms can be used by a prescriber, an enrollee, or the enrollee's representative to request a coverage determination for drugs not listed on the Formulary or for drugs that require a prior authorization in order to be covered.

Pharmacy Forms

Commercial Group and Individual Plan Formularies

Supplement Formulary Information

Medicare Advantage Formularies and Formulary Updates

Centennial Care Formularies

Centennial Care Provider Directories

Medication Therapy Management 2014

Disclaimer

Please be sure a prescription drug benefit is part of your specific coverage before consulting this list. If you do not know which list is correct, please contact the Presbyterian Customer Service Center at 505-923-5678 or 1-800-356-2219 for assistance. TTY users may call 1-877-298-7407.

Coverage for some drugs may be limited to specific dosage forms and/or strengths. Your benefit design determines what is covered for you and what your copayment will be. Please refer to your benefit materials for your specific coverage information.

The medications listed on this Formulary/Preferred Drug List (PDL) are subject to change pursuant to the Formulary/PDL management activities of Presbyterian Health Plan and Presbyterian Insurance Company, Inc. (Presbyterian). This list is not all-inclusive nor does it imply a guarantee of coverage. In addition, coverage for some drugs listed may be limited to specific dosage forms and/or strengths. Substitution of a generic product for a brand-name drug is mandatory when a generic equivalent is available. If a member requests the brand-name drug in this situation, a pharmacy exception may be required and the member must pay the difference in cost between the generic and branded versions. Non-formulary medications are not considered for coverage unless trial and failure of Formulary alternatives are documented.