​​​​​​The Presbyterian pharmacy benefit is an essential element in providing patients and members the medication they need while appropriately managing costs. Formularies include both brand name and generic medications that are commonly prescribed. Refer to our provider formularies to see if the drug you are prescribing is covered by the member’s plan.

Commercial Small and Large Group Plan Formularies

Information about prescription drug plans and a list of medications available to members in our small and large employer group plans who have prescription drug coverage provided by Presbyterian Health Plan.

• Commercial Small Group and Large Group Plans (Non-Metal Plans) – by Therapeutic Class
• Commercial Small Group and Large Group Plans (Non-Metal Plans) – Formulary Changes

Health Insurance Exchange Metal Level Plan Formularies

Information about prescription drug plans and a list of medications available to members on our individual and family plans or on a small employer group (1-50 employees) plans. (Applies to both on and off exchange plans.)

• 2017 Individual and Family Metal Plans/Employer Group Metal Plans (for plans effective in 2017)
• 2017 Individual and Family Metal Plans/Employer Group Metal Plans (for plans effective in 2017) – Formulary Changes
• 2018 Individual and Family Metal Plans/Employer Group Metal Plans (for plans effective in 2018)
• 2018 Individual and Family Metal Plans/Employer Group Metal Plans (for plans effective in 2018) – Formulary Changes

Medicare Advantage Formularies and Formulary Updates

List of drugs approved by the Centers for Medicare and Medicaid Services (CMS) — that are covered by Presbyterian’s Medicare Advantage prescription drug plans.

Presbyterian Senior Care HMO/MediCare PPO

Centennial Care Formularies

Information about prescription drug plans and a list of medications available to members on our Centennial Care plan.

• Centennial Care Formulary – Drugs by Therapeutic Class
• Centennial Care – Formulary Changes
• Drugs Requiring Prior Authorization for Centennial Care Plans

Supplement Formulary Information

• A list of drugs that have specific edits/requirements for coverage
• Specialty Pharmaceuticals/Medical Drugs List
• Formulary Addition Request Form
• Contraceptives Covered with No Co-Pay

U.S. Food and Drug Administration (FDA) Safety Alerts
U.S. Food and Drug Administration (FDA) Drug Recalls

Pharmacy and Therapeutics Committee Provider Update

• Pharmacy and Therapeutics Committee Provider Update Third Quarter 2018
• Pharmacy and Therapeutics Committee Provider Update Second Quarter 2018
• Pharmacy and Therapeutics Committee Provider Update First Quarter 2018
• Pharmacy and Therapeutics Committee Provider Update Fourth Quarter 2017