Switch to:
  • members
  • brokers
  • employers
  • Contact Us
EmblemHealth Logo.
EmbelmHealth Logo

Sign In

Sign In

Portal Training Materials

Provider Newsletter

Join Our Network
  • Contact Us
  • members
  • brokers
  • employers

Search

Popular Tasks

  • Provider Toolkit
  • Provider Portal Help
  • Learning Online
  • Join our Network
  • Pharmacy
  • Find a Dental Specialist
  • Provider Newsletter
  • In the Community
Contact Us
  • EmblemHealth Logo
  • Provider Resources
    • Key Resources/Provider Toolkit
    Provider Resources
    Key Resources/Provider Toolkit Request Provider Portal Account Our Companies, Lines of Business, Networks, and Benefit Plans Frequently Asked Questions Welcome materials, guides, and forms News and Updates Newsletters CAHPS Tips
    Connect Members to Care Access & Availability Standards Plans with No Referrals Referral Quick Guide Network Laboratories Urgent Care Center Locations Mental Health (Carelon) Find Care, search all in-network providers/facilities
    Learning Online/Required Trainings Find videos and guides Join Our Network Credentialing Forms and Information
  • Clinical Corner
    • UM and Medical Management
    • Care Management Programs
    Clinical Corner
    UM and Medical Management Preauthorization Lists Preauthorization Contacts Care Management Programs Help for patients with chronic or complex conditions
    Vendor-Managed Utilization Management Programs Behavioral Health Services Quality Improvement Programs and Resources Clinical Practice Guidelines
    Medical Policies Guidelines we follow Pharmacy Pharmacy Initiatives
    Provider quality improvement rubbon

    Quality Improvement

    Find our Quality Improvement programs and resources here.

    Search Our Quality Improvement Page
  • Claims Corner
    • Claims Resources
    Claims Corner
    Claims Resources Fee Schedule Updates Hospital Readmission Policy Electronic Claims Policy In-Office Testing List
    Submissions Claims Contacts EmblemHealth Guide for Electronic Claims Submissions Timely Submissions Claims Submissions
    Reimbursement Policies Consolidated Appropriations Act/No Surprise Billing Information Payment processes unique to our health plans Payment Integrity Policies How we pursue payment accuracy
    Coding EmblemHealth Guide for NPIs and Taxonomy Codes
  • Provider Manual
    Provider Manual
    Overview Directory Credentialing Member Identification Cards Member Policies and Rights Provider Networks and Member Benefit Plans
    Access to Care and Delivery System Health Promotion and Care Management Pharmacy Services EmblemHealth Spine Surgery and Pain Management Therapies Program Durable Medical Equipment Home Health Care
    SNF IRF LTAC Medical Transportation Procedures Utilization and Care Management Clinical Practice Guidelines Radiology Program Outpatient Diagnostic Imaging Privileging View All
    Provider manual

    Provider Manual

    Find the specific content you are looking for from our extensive Provider Manual.

    Search the Provider Manual
  • Dental Corner
    • Resources for Dental Providers
    Dental Corner
    Resources for Dental Providers Benefits to Participation in Dental Network Join Our Dental Networks
    Welcome Dental Providers Find a Dentist
    Dentists Contact Us Update Your Practice Records
  • Sign In

EmblemHealth Formularies

  1. Home
  2. Home
  3. Clinical Corner
  4. Pharmacy
  5. Formularies

We cover pharmacy benefit services for many of our members covering a wide range of prescription drugs. Select the applicable line of business below to navigate to the applicable formulary.

 

2025 EmblemHealth Formulary Changes
  • Medicare Formularies
    Go to Medicare Formularies
  • Commercial Formularies
    Go to Commercial Formularies
  • Medicaid Formulary
    Go to Medicaid Formulary
We use cookies on this website to give you the best experience and to measure website usage. By continuing to use this website, you consent to these cookies. View our Privacy Policy here.
  • Provider Portal
  • Sign In
  • Training Material
  • New Account Request Form
  • Portal FAQs
  • Quick Links
  • Join Our Network
  • Office Visit Newsletter
  • Learning and Required Trainings
  • Provider Toolkit
  • Member ID Cards
  • Member Materials
  • Careers
  • Family of Companies
  • Summary of Companies
  • Neighborhood Care
  • AdvantageCare Physicians
  • Support
  • Contact Us
  • FAQs
  • Language Assistance
Also of Interest: 
Formulary Updates   |   2022 EmblemHealth Formulary Changes   |   2025 EmblemHealth Formulary Changes
  • Legal   |  
  • Legal Information   |  
  • Nondiscrimination Policy   |  
  • Accessibility Statement   |  
  • Privacy & Security Policy   |  
  • Stop Fraud   |  
  • Required Provisions

©2025 EmblemHealth. All Rights Reserved.

Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office. Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.

Provider Portal
  • facebook
  • instagram
  • linkedin
  • twitter
  • youtube

Enter your ZIP code:
Continue