Search for in-network pharmacy locations worldwide
Providence Health Plan is pleased to provide plan members with a comprehensive prescription drug formulary designed to promote safe, effective and affordable drug therapy.
- It’s easy to search.
- Includes information about the medication.
- Includes special considerations about the prescription, if they apply.
Search the formulary
There are a number of ways to see if your prescription is included in the formulary. You can search:
- By entering a portion of the drug name; and/or
- By therapeutic class.
Which formulary applies to me?
Find your medical plan on one of the grids below to determine which formulary applies to you. First, how did you purchase your medical coverage?
2020 plan formularies
2021 plan formularies
If you are employed by one of the following, select your formulary:
Medicare and Medicaid
Tip: There may be times when you require a medication that is not on the formulary. If you currently take a prescription drug not on the formulary, contact customer service to make sure the drug is not covered. If the prescription drug is not covered, your provider may request an exception be made.
Medical benefit drug prior authorization
The following list is intended to provide guidance regarding coverage of healthcare services and are not all-inclusive. Additional exclusions may apply based on benefit and contract terms.
For all member plan types. For pharmacy benefit drug prior authorization information, please refer to your current formulary.
Drug prior authorization forms
Infusion Therapy Site of Care Policy – Commercial Members (Individual, Small Group and Large Group Plans)
Providence Health Plan (PHP) requires site of care prior authorization for certain medications when given in an unapproved hospital setting. A separate prior authorization may be required for the drug. Click on the Approved Site of Care List (PDF) below for the full announcement.