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You will find the most up-to-date information about pharmaceutical management procedures and formularies on our EmblemHealth Web site, including:
Pharmacy benefit designs
Prior authorization criteria
Procedures for generic substitution, therapeutic interchange, step therapy or other management methods to which the practitioner’s prescribing decisions are subject
Any other requirements, restrictions, limitations or incentives that apply to the use of certain pharmaceuticals
For the latest updates to our Commercial and Medicare formularies, please go to the Formulary Updates on Clinical Corner. Should you have any questions regarding our pharmaceutical management procedures, please contact EmblemHealth’s Clinical Pharmacy Services at 1-877-444-3657. For information on specialty medications, please call the Specialty Pharmacy department at 1-888-447-0295.