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The formulary is a list of brand-name, generic and specialty medications developed by physicians and pharmacists for the purpose of promoting safe, effective and affordable drug therapy. All medications on the Providence formulary have Food and Drug Administration (FDA) approval. The formulary can help you and your physician choose effective medications that minimize your out-of-pocket expense.
Formulary search tip: Looking for something specific? Within the document you wish to search, type "F" while holding the "CTRL" button to access the "Find" feature. Type what you’re looking for in the box that appears and click "Enter."
Individual and family plans
For members with prescription drug coverage not
through an employer.
Small group plans
For members with prescription drug coverage through an employer of 50 or fewer employees.
Large group plans
For members with prescription drug coverage through an employer of 51 or more employees.
For members with prescription drug coverage through one of the following groups.
Medicare and Medicaid
Medical benefit drug prior authorization
For all member plan types except Medicare. For pharmacy benefit drug prior authorization information, please refer to your current formulary.
Prior authorization forms