Which drugs are covered by my plan?
You can see the list of drugs covered by your EmblemHealth plan below. This drug list is also known as a formulary. To find your plan’s formulary, simply locate the letter identifiers in the “Formulary” section on the front of your member ID card, which will match one of the options found in parenthesis below.
2024 Essential Plan Formulary (EP)
The list of drugs we cover under the Essential Plan for New York State of Health members.Last Updated: 02/01/2024
2024 Qualified Health Plan Formulary (QHP)
The list of drugs we cover under the Qualified Health Plan for New York State of Health members.Last Updated: 02/01/2024
2024 Small Group Formulary (SG)Last Updated: 02/01/2024
2024 Large Group Formulary (LG)
The list of drugs we cover under the large group formulary.Last Updated: 01/01/2024
2024 Large Group Legacy Formulary (LGL)
The list of drugs we cover under the large group legacy formulary.Last Updated: 01/01/2024
2024 Child Health Plus Formulary (CHP)
The list of drugs we cover under the Child Health Plus formulary.Last Updated: 01/01/2024
Delivery and Refills
Find out how to set up home delivery or a get a prescription refill.
Medication Therapy Management
Find out if you qualify for this service, which is free for EmblemHealth Medicare plan members with Part D prescription drug coverage.
KNOW YOUR RIGHTS
Grievances and Appeals
Find out how to file a grievance or an appeal, request coverage decisions and determinations, and more.
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 your member ID card.