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Welcome to Summit Health

Formulary


Our formulary is our 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.

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

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:

Last updated Oct. 1, 2021
H2765_4006

Contact us

Call 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, with the exceptions of Christmas Day and Thanksgiving Day.
After March 31, your call will be handled by our automated phone system on weekends and holidays.

Get more contact details

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