Which drugs are covered by my plan?

Looking for Medicare formularies


Plan formularies

You can see the list of drugs covered by your EmblemHealth plan below. This drug list is also known as a formulary.

  • 2021 Essential Plan Formulary

    The list of drugs we cover under the Essential Plan for New York State of Health members. It is up to date as of November  1, 2020.

  • 2020 Essential Plan Formulary

    The list of drugs we cover under the Essential Plan for New York State of Health members. It is up to date as of November  1, 2020.

  • 2021 Qualified Health Plan Formulary

    The list of drugs we cover under the Qualified Health Plan for New York State of Health members. It is up to date as of November 1, 2020.

  • 2020 Qualified Health Plan Formulary

    The list of drugs we cover under the Qualified Health Plan for New York State of Health members. It is up to date as of November 1, 2020.

  • 2020 Large Group Formulary

    The list of drugs we cover under the large group formulary. It is up to date as of October 1, 2020.

  • 2020 Small Group Formulary

    The list of drugs we cover under the small group formulary. It is up to date as of October 1, 2020.

  • 2020 Child Health Plus Formulary

    The list of drugs we cover under the Child Health Plus formulary. It is up to date as of October 1, 2020.

YOUR MEDICATION

Delivery and Refills

Find out how to set up home delivery or a get a prescription refill.

MTM PROGRAM

Medication Therapy Management

Find out if you qualify for this service, which is free for EmblemHealth Medicare plan members with Part D prescription drug coverage.

KNOW YOUR RIGHTS

Grievances and Appeals

Find out how to file a grievance or an appeal, request coverage decisions and determinations, and more.

If you are not sure which formulary your plan uses or have any other questions, call your employer’s benefit administrator or EmblemHealth Customer Service at the number on your member ID card.

HELP AND SUPPORT

Pharmacy Support

Search your plan formulary, find participating pharmacies, and access forms.