What is a formulary?

A formulary is a list of medications and other healthcare products that are covered by a health insurance plan, such as an HMO or PPO. Formularies are created by healthcare providers, such as the Washington State Health Care Authority, in order to help ensure that patients receive the most cost-effective and appropriate treatments. The formulary helps to control costs by encouraging the use of generic drugs and discouraging the use of more expensive brand-name drugs. It also ensures that all medications and treatments are medically necessary and are proven to be cost-effective. The formulary may also contain information about the level of coverage that the insurer provides for each medication or treatment. All Washington residents with health insurance coverage must have access to a formulary, and it must be updated annually.

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