FORMULARY D
How to Search for Drugs
COVID-19 Vaccination
Vaccination is a safe, effective, and reliable way to prevent getting sick from COVID-19. Getting vaccinated is one of the best ways to protect you and your family.
COVID 19 vaccines are available at no cost
All FDA-authorized and FDA-approved COVID-19 vaccines are provided at no charge to you, no matter where you get the vaccine. This includes when multiple doses are required and recommended boosters.
Influenza
Influenza - also known as the flu - is a highly contagious respiratory virus. The effects of the flu vary from person to person and rand from mild to sever. The best protection against the flu is to get a flu shot each year.
Did you know that you may be able to get a flu shot at an in-network pharmacy?
To find an in-network pharmacy: You can call Customer Service at 503-574-7500 (TTY: 711), Pharmacy Services at 503-574-7400 (TTY: 711), or access the Pharmacy Directory.
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Prescription drug coverage
Generally, your prescription drug plan covers prescription drugs that:
Formulary exceptions / Generic alternatives
Formulary Exception: There may be times when you require a drug that is not on the formulary. If you currently take a prescription drug not on the formulary, contact customer service to make sure the drug is not covered. If the prescription drug is not covered, your provider may request an exception be made. There are two ways you, your representative, or prescriber can initiate a prior authorization request: Complete the Providence Health Plan drug coverage prior authorization form or your provider may use the drug prior authorization form to submit the exception request.
Generic Alternatives: A generic alternative is a generic drug that is used to treat the same condition as a brand-name drug. It is not the exact same medication as the brand-name drug. According to clinical evidence, a generic alternative can be expected to treat the same condition as well as the brand-name alternative. A new prescription is needed to obtain a generic alternative drug. You may search the formulary by medical condition and look for a medication classified as a generic.
More Information
Visit the Providence Health Plan Pharmacy Resources page for more information about prescription drugs, including forms, articles, and answers to frequently asked questions.
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