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Drugs Covered by EmblemHealth Health Plans | EmblemHealth

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Drugs Covered

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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.

  • 2024 Essential Plan Formulary

    The list of drugs we cover under the Essential Plan for New York State of Health members. 

     Last Updated: 11/01/2023

  • 2024 Qualified Health Plan Formulary

    The list of drugs we cover under the Qualified Health Plan for New York State of Health members.

     Last Updated: 11/01/2023

  • 2024 Small Group Formulary

    Last Updated: 11/01/2023

  • 2024 Large Group Formulary

    The list of drugs we cover under the large group formulary.

     Last Updated: 10/01/2023

  • 2024 Large Group Legacy Formulary

    The list of drugs we cover under the large group legacy formulary.

     Last Updated: 10/01/2023

  • 2024 Child Health Plus Formulary

    The list of drugs we cover under the Child Health Plus formulary.

     Last Updated: 10/01/2023

  • 2023 Essential Plan Formulary

    The list of drugs we cover under the Essential Plan for New York State of Health members. 

     Last Updated: 11/01/2023

  • 2023 Qualified Health Plan Formulary

    The list of drugs we cover under the Qualified Health Plan for New York State of Health members.

     Last Updated: 11/01/2023

  • 2023 Small Group Formulary

    The list of drugs we cover under the small group formulary.

     Last Updated: 11/01/2023

  • 2023 Large Group Formulary

    The list of drugs we cover under the large group formulary.

     Last Updated: 10/01/2023

  • 2023 Large Group Legacy Formulary

    The list of drugs we cover under the large group legacy formulary.

     Last Updated: 10/01/2023

  • 2023 Child Health Plus Formulary

    The list of drugs we cover under the Child Health Plus formulary.

     Last Updated: 08/01/2023

YOUR MEDICATION

Delivery and Refills

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

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.

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.

ALSO OF INTEREST

Pharmacy GHI CBP Medicare Formularies

Find a doctor or medical office

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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.