Close Icon Dismiss modal Close Icon Dismiss modal External Icon Link to an external resource Gear Icon Display options X Icon X Icon Plus Icon Minus Icon Arrow Right Arrow Left Arrow Up Arrow Down Calendar Edit Refresh First Last Question Info Block PDF PDF Document Word Word Document Excel Excel Document Powerpoint Powerpoint Document Active Checkbox Checked checkbox Active Radio Selected radio button Checkmark Error Warning Visibile Hidden

Welcome to Summit Health

Formulary


Use our 2021 formulary (En Español) (list of covered prescription drugs) to see what generic and brand-name drugs are covered under our plans that have prescription drug coverage. Please note, this formulary may change. Please see our formulary updates to view changes. 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. You can also contact pharmacy customer service to request a printed copy of the formulary.

Contact

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

We may make changes to the formulary. Changes may include:
  • 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.

Making an exception

We may be able to cover a drug for you if you ask us to make an exception. You can request an exception if:

  • Your Part D-eligible drug is not on our formulary
  • We ask you to try another drug before you receive a drug you have requested
  • We limit the quantity or dose of a drug you have requested

To request an exception, you or your provider may do one of the following:

  • Complete our online coverage determination and exception request (members and providers) 
    (available after 01-01-21)
  • Contact Summit Health Pharmacy Customer Service at 844-827-2355 (TTY users, please call 711).
  • Mail your request by completing this coverage determination and exception request form

Last updated Dec. 17, 2020
H2765_4006

Contact us

Have questions? We’re here to help. Call us today at 844-827-2355 (TTY users, please call 711). Our customer service team is available 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.

Get more details



....