Pharmacy Services


Our goal is to optimize patient outcomes through the use of medications that have established efficacy and safety data while also providing the greatest value.

Notifications

Effective Date: Description of updates:
July 1, 2019 Site of Care Policy
Daily limits to diabetic supplies
Step Therapy requirements for select diabetes drugs


Medications requiring prior authorization: Certain drugs on the formulary require prior authorization, and will not be approved for payment until the conditions for approval of the drug are met and the authorization has been entered into the system. Please visit the PHP Portal to access prior authorization criteria, available here: MyPHP

The prescription drug formulary can be accessed here: Prescription Drug Formularies

Medications administered or billed through the medical side (requires HCPCS code) can be found here: Medication Notification Table

The medication prior authorization form can be found here: Medication Prior Authorization Form


Archived Notifications

Effective Date: Description of updates:
January 1, 2019 Formulary Exclusions
Formulary Changes and Additions
October 1, 2018 Expanded Vaccine coverage at pharmacies
January 1, 2018 Statins available at $0 copay






Please note: Medications requiring prior authorization, as well as criteria for use, are subject to change. For the most up-to-date information on coverage and cost of a medication, you may call the PHP Customer Service Department at 1.800.832.9186. Coverage is based on the Member's benefit plan.

This page last updated May 1, 2019.