Drug Formulary

Group Health's drug formulary is a list of medications covered by your health plan.

Individual & Family Plans, and Small Employer Group Plans

Information about prescription drug plans and a list of medications available to members in our individual and family plans, or in small employer group (1-50 employees) plans. Note: If your small employer group plan hasn't renewed yet in 2014, use the Large Employer Group information below until renewal. If you have questions, contact Customer Service.

Medicare Advantage Plans

List of drugs selected by Group Health Cooperative and Group Health Options, Inc. — and approved by the Centers for Medicare and Medicaid Services (CMS) — that are covered by Group Health's Clear Care prescription drug plans.

Large Employer Group Plans

Information about prescription drug plans and a list of medications available to members in our large employer group (51+ employees) plans.

Large Employer Group Plans Formulary Search

You can search drugs by name or therapeutic class to see if they are in our formulary and whether they require a prescription or prior authorization.

Search by Medication Name

Please enter the name of the drug you are searching for without using special characters such as *, %, or &.

Enter the entire drug name or just the first few letters.

Search by Therapeutic Class

Prior Authorization and Nonformulary Drug Exception Requests

You or your doctor can request coverage for prior authorization drugs or nonformulary drugs. Your request will be reviewed based on our coverage criteria or medical necessity. If we approve the request, you will pay a cost share determined by your member contract. If we do not approve the request, you may still choose to get the medication and pay full price. For more information, see About Our Drug Formulary.