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What is a drug formulary?

It sounds complicated, but is it? Find out what a drug formulary is and what you should know before you fill that prescription.


By Betsy Niemela
August 4, 2017

     


When I go to the grocery store to buy, say, canned tomatoes, I have a lot of choices: diced or whole, organic, generic or brand name, just for starters. And if I walk into a different grocery store, I'll find a slightly different variety of tomatoes at slightly different prices.

This is kind of how a drug formulary works. It’s an assortment of medicines, managed by a health plan. Just like a grocery store has its own inventory of tomatoes, each health plan has its own list of approved medicines, handpicked for its plan members. It includes thousands of brand-name, generic and specialty medicines.

8 things to know about drug formularies

Related content: Tips for saving at the pharmacy

No surprises

When in doubt, I recommend checking with your health plan before filling a new prescription. You can make sure it's covered, get an estimate of how much it will cost and, in some cases, find the lowest price pharmacy in your area. And if it's not covered, find out what other options are available. Then, have a conversation with your doctor to see if the alternative(s) is a good choice for you.

All of this takes time, so it's better to know before you go to the pharmacy. Remember, you can always call the member services number on the back of your insurance card if you need help with any pharmacy related questions.

Hey, HealthPartners members!

You can search your drug list, find out how much your plan covers and which pharmacy has the best price here.

Betsy Niemela

Betsy Niemela is a Pharmacy Programs Manager at HealthPartners and a regular contributor to the HealthPartners Health Insurance Help blog. She knows how overwhelming health care can be, and enjoys helping members navigate confusing and frustrating issues and learning from those instances. Outside of work, Betsy enjoys sketching, painting and music. She also loves hiking with her dog Chester and enjoying Minnesota’s four seasons.

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