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.
- 2021 High Performance Formulary for ACA Plans
- 2020 High Performance Formulary for ACA Plans
- 2020 Incentive Formulary
- 2021 Enhanced Formulary
Members: Register or login to myplan.healthplan.org to access your pharmacy benefits or to use the "Find a Drug" tool.
NOTE: We may add or remove drugs from our formulary during the year. To inquire about the status of a drug on the formulary, please contact our Pharmacy Service Department at 1.800.624.6961, ext. 7914, 24 hours a day, 7 days a week.
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 firstname.lastname@example.org or by filling out the online Formulary Exception Request form.