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Drug list (formulary)
A comprehensive formulary is a complete list of prescription drugs covered by the plan. The drugs on this list are chosen by the plan, with the help of doctors and pharmacists. The drug list tells you if there are any rules you need to follow to get your drugs.
AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid plan) will generally cover the drugs listed in our formulary as long as the drugs are medically necessary. The prescription also needs to be filled at an in-network pharmacy, and other plan rules need to be followed.
The drug list has been reviewed and approved by the Centers for Medicare & Medicaid Services (CMS), the agency that administers the Medicare program. Medications on the drug list are approved by the Food and Drug Administration (FDA) and have been chosen for their reported medical effectiveness and value. The drug list is updated at times throughout the year, and the list of drugs may change.
AmeriHealth Caritas VIP Care Plus covers both brand name drugs and generic drugs. Generic drugs have the same active ingredients as brand name drugs. Generic drugs usually cost less than brand name drugs and are rated by the FDA to be as safe and effective as brand name drugs.
Want regular information about your pharmacy benefits? Look for your monthly Explanation of Pharmacy Benefits in the mail.
To ask for a hardcopy of the Drug list (formulary), call member services at 1-888-667-0318 (TTY 711), 8 a.m. to 8 p.m. We will mail it to you.