Formularies

THP Rx offers various plans that cover generic, brand name and non-formulary options. Our formularies are developed to meet the members' needs in a clinical cost-effective manner.

NOTE: We may add or remove drugs from our formulary during the year. 

 

For Existing Members

Members can also view your plan’s selected formulary through Myplan.healthplan.org/Online Pharmacy as an interactive tool that displays the formulary status and pricing information of every medication. Please keep in mind that certain drugs may be subject to coverage management rules. 

 

Is your medication not on the list?

Members or physicians may request an exception to a drug that is not on our formulary list, if the drug is medically necessary. The Health Plan makes its determination on a standard exception and notifies the member or his/her practitioner no later than 72 hours following the receipt of the request. 


Is your medication not on the list?

Members or physicians may request an exception to a drug that is not on our formulary list, if the drug is medically necessary. The Health Plan makes its determination on a standard exception and notifies the member or his/her practitioner no later than 72 hours following the receipt of the request.

A faster process can be requested if a covered member has a condition that may seriously jeopardize his/her life, health or ability to regain maximum function or is undergoing a current course of treatment using a non-formulary drug. In these cases, The Health Plan will make its determination and provide notice no later than 24 hours following the receipt of the request.

The exception process can be initiated by the member or the physician by calling Pharmacy Services at 1.800.624.6961, ext. 7914 or emailing pharmacyservices@healthplan.org or by filling out the online Formulary Exception Request form.