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Covered Drugs

Download copies of claims forms and learn more about your pharmacy benefits and more.

2018 Essential Formulary +

The list of drugs we cover under the Essential Plan for New York State of Health members. It is up to date as of
January 1, 2018

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2018 Qualified Health Plan Formulary +

The list of drugs we cover under the Qualified Health Plan for New York State of Health members. It is up to date as
of January 1, 2018

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2017 EmblemHealth Enhanced Care Prime Network Formulary +

A guide to and list of the drugs we cover for these members effective 1/1/2016.

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2017 Premier Formulary +

A list of most common preferred drugs for members of Large group plans (over 50 eligible), and the New York State-sponsored Child Health Plus program.

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2017 Select Formulary Summary +

This is a list of the most commonly prescribed preferred drugs for members with the Select Formulary (Effective January 1, 2017).

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2017 EmblemHealth Select Care for NY State of Health Formulary +

For members both on the NY State of Health Exchange and off, a guide to and list of the drugs we cover for members of Small Group (100 or fewer eligible) and Direct Pay (Individual) plans effective 1/1/2014.

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If you are not sure which formulary your plan uses or have any other questions, call your employer’s benefit administrator or EmblemHealth Customer Service at the number on the back of your ID card.

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Your member ID # is on the front of your ID card.