Drugs Covered

Older man with beard talking to female pharmacist.

Which drugs are covered by my plan?

Looking for Medicare formularies


 

Plan formularies

You can see the list of drugs covered by your EmblemHealth plan below. This drug list is also known as a formulary.

  • 2021 Essential Plan 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 September  1, 2021.

  • 2021 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 September 1, 2021.

  • 2021 Small Group Formulary

    The list of drugs we cover under the small group formulary. It is up to date as of September 1, 2021.

  • 2021 Large Group Formulary

    The list of drugs we cover under the large group formulary. It is up to date as of July 1, 2021.

  • 2021 Child Health Plus Formulary

    The list of drugs we cover under the Child Health Plus formulary. It is up to date as of July 1, 2021.

pharmacy

YOUR MEDICATION

Delivery and Refills

Find out how to set up home delivery or a get a prescription refill.

pharmacy

MTM PROGRAM

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.

pharmacy

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.

HELP AND SUPPORT

Pharmacy Support

Search your plan formulary, find participating pharmacies, and access forms.

Pharmacist smiling at male customer.