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Drugs Covered

Which drugs are covered by my plan?
Plan formularies
You can see the list of drugs covered by your EmblemHealth plan below. This drug list is also known as a formulary.
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2023 Essential Plan NPF 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 June 1, 2023.
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2023 Qualified Health Plan NPF 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 June 1, 2023.
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2023 Small Group NPF Formulary
The list of drugs we cover under the small group formulary. It is up to date as of June 1, 2023.
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2023 Large Group NPF Formulary
The list of drugs we cover under the national preferred formulary. It is up to date as of April 1, 2023.
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2023 Large Group ASO Formulary
The list of drugs we cover under the large group formulary. It is up to date as of April 1, 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.