The pharmaceuticals on the Commercial and Medicare formularies are selected by specialty subcommittees and decided on by the Pharmacy & Therapeutics (P&T) Committee. Members of these committees include EmblemHealth network physicians of various specialties, pharmacists and administrators. The committees meet regularly and the drug formularies are updated regularly through formulary updates.
Updates to the Commercial formulary apply to EmblemHealth, GHI, HIP and Vytra benefit plans. Updates to the Medicare formulary apply to EmblemHealth and ConnectiCare benefit plans. Exceptions will be noted.
Commercial and Medicaid Formulary Updates
Use the Formulary Search (for EmblemHealth, GHI, HIP and Vytra Commercial benefit plans) or the Medicare Formulary Search (for EmblemHealth Medicare plans) to determine whether a specific drug is covered by a member’s health plan.
You can also access the Pharmacy Services chapter of the Provider Manual for more information about our program. If you have any questions, please contact EmblemHealth’s Pharmacy Clinical Department at 1-877-362-5670.
Providers contracted to serve our EmblemHealth Medicaid and Family Health Plus members must prescribe drugs in our Medicaid/Family Health Plus Formulary. You may locate formulary medications through our Medicaid/Family Health Plus formulary search.