What's Covered/Formulary

The following Preferred
Medication List/Formulary (PML) can assist
you in choosing a generic or brand-name medication.
- Generic
Medications - A large number of generic
medications are available. If you choose a generic,
you will most likely pay the least amount for these
medications. Generics provide the same high quality
and therapeutic benefit as brand-name medications, without
the brand-name price.
- Brand-Name
Medications - Brand-name medications listed
on the PML/Formulary are available at your brand copay
(or coinsurance) level. They are owned (protected by
patent) and manufactured by a specific company. When
the patent expires on a brand-name medication, that
medication can then be manufactured and distributed
by other companies.
Healthy
Options OTC Formulary - The following over-the-counter
products are covered for Asuris Northwest Health and Regence
BlueShield Healthy Options members only and are benefit
exclusions on most other plans.
Non-Formulary Medications
Any medication not listed on the PML is not on the formulary.
If you have a three-tier
copay/coinsurance plan, the non-formulary medication
is only available at the highest copayment or at your own
expense if you have a closed
formulary design.
View a list of Alternatives
to Non-Formulary Medications.
Questions?
If you have questions about your prescription benefits, please call Customer
Service at the number on the back of your member card, or the TTY line for people
with hearing impairments at 1 (800) 382-1003.
We encourage you to share this information with your doctor
and other medical providers.
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