Drug Name Search

Enter a drug name to begin

Disclaimer: Depending on your plan benefit, the cost share for brand name drugs with a generic equivalent may be greater than the tier status. Please see your benefit summary or contact the Pharmacy Department at (877)216-3644 for questions.

By Alphabet

Select a letter to view drugs starting with that letter

Legend

T0

ACA Preventive
T1

Generic
T2

Brand
T3

Specialty
PMS

Preferred Medical Supply
NF

Non-Formulary

QL

Quantity Limit
PA

Prior Authorization
ST

Step Therapy
LA

Limited Access
C

Custom
S

Specialty Drug
MED

Medical Drug
AQ1

Age Quantity Limit
AQ2

Age Quantity Limit
QLC

Quantity Limit (Custom)

BRAND NAMES

generic names

2022 PROVIDENCE FORMULARY A

Welcome

Providence Health Plan is pleased to provide plan members with a comprehensive prescription drug formulary designed to promote safe, effective and affordable drug therapy. We cover 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.

COVID-19 Vaccination

Vaccination is a safe, effective, and reliable way to prevent getting sick from COVID-19. Getting vaccinated is one of the best ways to protect you and your family.

COVID-19 vaccines are available at no cost
All FDA-authorized and FDA-approved COVID-19 vaccines are provided at no charge to you, no matter where you get the vaccine. This includes when multiple doses are required and recommended boosters.

Everyone 6 months of age and older is eligible to get a COVID-19 vaccine

The most current vaccine information, including recommendations for boosters and special populations, can be found on the CDC website.

For the most update to information on COVID-19 Vaccine, please visit our Frequently Asked Questions (FAQ) page.

Influenza

Influenza — also known as the flu — is a highly contagious respiratory virus. The effects of the flu vary from person to person and range from mild to severe. The best protection against the flu is to get a flu shot each year.

Did you know that you may be able to get a flu shot at an in-network pharmacy?

Flu vaccines are available at many retail pharmacy locations or through your in-network health care provider.

Going to the pharmacy is a convenient option as generally no appointment is needed and flu shots are covered at no cost to our members with proof of insurance.

To find an in-network pharmacy: You can call Customer Service at 503-574-7500 (TTY: 711), Pharmacy Services at 503-574-7400 (TTY: 711), or access the Pharmacy Directory.

Search the formulary

There are a number of ways to see if your prescription is included in the formulary. You can search:

Use the alphabetical list to search by the first letter of your medication.

Search by typing part of the generic (chemical) and brand (trade) names.

Printable Files

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Prescription drug coverage

Generally, your prescription drug plan covers prescription drugs that:

Are medically necessary;

Are filled at an in-network pharmacy; and that

Meet the criteria described in your member materials, such as prior authorization and step-therapy, when needed. Your member materials, including your prescription drug benefit summary, are available through myProvidence when you create a free account.

Formulary exceptions / Generic Alternatives

Formulary Exception: There may be times when you require a drug that is not on the formulary. If you currently take a prescription drug not on the formulary, contact customer service to make sure the drug is not covered. If the prescription drug is not covered, your provider may request an exception be made. There are two ways you, your representative or prescriber can initiate a prior authorization request: Complete the Providence Health Plan drug coverage prior authorization form or your provider may use the drug prior authorization form to submit the exception request.

Generic Alternatives: A generic alternative is a generic drug that is used to treat the same condition as a brand-name drug; it is not the exact same medication as the brand-name drug. According to clinical evidence, a generic alternative can be expected to treat the same condition as well as the brand-name alternative. A new prescription is needed to obtain a generic alternative drug. You may search the formulary by medical condition category and look for a medication classified as generic.

More information

Visit the Providence Health Plan Pharmacy Resources page for more information about prescription drugs, including forms, articles, and answers to frequently asked questions.