Abridged Formulary Addendum
Last updated: February 2013
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Prior Authorization and
Prior Authorization Criteria
Step Therapy Criteria
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What Is a Formulary?
A formulary is the list of drugs that are covered by your Peoples Health plan. For the drugs listed on the Peoples Health 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's Evidence of Coverage.
Peoples Health covers both brand-name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand-name drug. Generic drugs usually cost less than brand-name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand-name drugs.
The Peoples Health formulary may change during the year. Please refer to your plan Evidence of Coverage for details on how Peoples Health will cover drugs that are affected by a change in our formulary.
Providers: To make a prior authorization request or a tiering/formulary request, download the Pharmacy Request Form below.
Pharmacy Request Form
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