See if a prescription drug is covered by Peoples Health.
Note: If you are a PHN Employee Plan member, click here to access your plan’s search tool.
Choose your plan from the Select a Plan drop-down menu. Enter the full name or part of the name of the prescription drug
you are searching, or choose an option from the therapeutic category list. Then click the Search button.
What is a formulary?
A formulary is a list of drugs covered by a health plan. The Peoples Health formulary covers drugs that are selected by Peoples Health in consultation with a team of healthcare providers and that represent the prescription therapies believed to be a necessary part of a quality treatment program.
Our “abridged formulary” is a partial listing of some of the drugs covered by Peoples Health. You can find a PDF of our abridged formulary in the sidebar to your left.
Our “comprehensive formulary” is a complete listing of all of the drugs covered by Peoples Health. Our comprehensive formulary is available through this online search. You can also find a PDF of our comprehensive formulary in the sidebar to your left.
Our formulary may change during the year. Please refer to your plan Evidence of Coverage for details on how we will cover drugs that are affected by a formulary change. If Peoples Health does not cover your drug, you can ask us to make an exception and cover your drug. Click here for information on how to request an exception (which is a type of coverage determination).
For the drugs on our formulary, Peoples Health pays for the majority of the drug's costs, and you pay a copay or a coinsurance amount for the rest of the cost. Your copay and coinsurance amounts are listed in your plan Evidence of Coverage.
Peoples Health covers both brand drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand drug. Generic drugs usually cost less than brand drugs and are rated by the Food and Drug Administration to be as safe and effective as brand drugs.
Call toll-free at 1-800-978-9765 to speak with a plan representative, seven days a week, from 8 a.m. to 8 p.m. TTY users may call 711.
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums, and copayments or coinsurance may change on January 1 of each year. The formulary, pharmacy network, and provider network may change at any time. You will receive notice when necessary. You must continue to pay your Medicare Part B premium. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. Peoples Health is rated 4.5 out of 5 stars for 2018. The “highest-rated” designation is based on the Medicare star ratings for Medicare Advantage and Special Needs Plans listed in the CMS publication “Medicare & You 2018.”
Peoples Health Network is the administrator for Peoples Health, Inc.
Peoples Health is a Medicare Advantage organization with a Medicare contract to offer HMO plans. Enrollment depends on annual Medicare contract renewal.
Page Last Modified: October 19, 2017 at 3:13 pm
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