Formularies continue to increase in complexity, and changes to those formularies are especially challenging for consumers to navigate.

Covered drugs are arranged by cost in tiers or levels. Generics are in the lowest tiers and are generally the lowest cost. Coverage and drug lists vary from plan to plan. Plans can change covered ...

Why aren’t all drugs covered by insurance? A formulary is the list of prescription medications covered by a health insurance plan. The list typically has brand-name and generic options. In addition to ...

When the user enters a drug into the text box and clicks search, the system searches the current formulary first (brand and generic names). If a match is found for a particular medication, the salt ...

The IRA requires health plans serving the Part D market to cover all negotiated drugs, and it has been predicted that CMS ...

Sheldon S. Sones, RPh, FASCP, is president of Sheldon S. Sones and Associates, a pharmacy and accreditation consulting firm based in Newington, Conn. Q: Is there a certain format that has to be used ...

As health care moves toward a value-based payment model, the pharmacy benefit is going in the opposite direction, one that places unit cost over clinical appropriateness. Have you ever used your drug ...

Why aren't all drugs covered by insurance? A formulary is the list of prescription medications covered by a health insurance plan. The list typically has brand-name and generic options. In addition to ...