Formulary

Our formulary is our list of covered generic and brand-name prescription drugs for plans that have prescription drug coverage To view the formulary you can:

• Download the formulary (please note, this formulary may change)
  • 2023 plans formulary (English)
  • 2023 plans formulary (En Español)
• Request a printed directory by emailing
  • PharmacyMedicar@yoursummithealth.com
• Call Pharmacy Customer Serive
  • 844-827-2355 (TTY users, please call 711)

If you do not see the drug you are looking for in the formulary, please call our pharmacy customer service. We may cover that drug.

Pharmacy customer service

Please call our Summit Health Customer Service at 844-827-2355 (TTY users, please call 711). Customer Service is available to help you from 7 a.m. to 8 p.m., Pacific Time, seven days a week from Oct. 1 to March 31. After March 31, your call will be handled by our automated phone system on weekends and holidays. Weekend calls are forwarded to voicemail and returned the next business day.

Formulary updates

• Adding or removing drugs. This happens if a drug is recalled or not working, or a new drug becomes available
• Moving a drug to a higher or lower cost-sharing tier
• Adding or removing a restriction on coverage
• Replacing a brand-name drug with a generic drug

If we make changes to a drug you are taking, we will send you a notice. We will also post any changes for our formulary, with dates, on this page.

Formulary exceptions

To request a prescription drug coverage determination, redetermination, or prior authorization, see our pharmacy coverage determination.