What is a formulary?

A formulary is a list of prescription drugs that is managed by a health insurance plan. The list includes both generic and brand-name drugs. In Maryland, the formulary is created and maintained by the health insurance company, with input from doctors and other medical experts. Formularies are designed to provide Maryland consumers with access to medications that have been proven to be effective and safe, while ensuring that their healthcare costs remain affordable. Generally, formularies are organized so that the most cost-effective medications are at the top of the list, and the least cost-effective medications are at the bottom. Formularies also help to reduce the cost of medications for members of the plan. Drugs listed on the formulary are usually covered by the health plan, while drugs that are not listed may not be covered. Each health plan has its own formulary, and members should check with their plan to find out which medications are covered. When a doctor prescribes a particular medication, it is important to check if the medication is on the formulary. If it is not, the patient may be able to get it approved by the health plan, or they may decide to switch to a medication that is covered by their plan.

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