Presbyterian | Summer 2019 | Your Story

Here are some important things to know about your prescription drug coverage: Presbyterian Centennial Care covers drugs listed on the Formulary. ● ● A Formulary is a list of approved prescription drugs that Presbyterian Centennial Care will cover. A Formulary is also called a Preferred Drug List. ● ● The Formulary includes notes and explains limits to your coverage. ● ● Please call the Presbyterian Customer Service Center (PCSC) if you would like to learn more about the drugs on the Formulary. Your providers and pharmacy (drug store) also have a copy of our Formulary. You can find the Formulary on our website at www.phs.org . Search for “Pharmacy Resources.” ● ● Most of the drugs on the Presbyterian Centennial Care drug list are generic. This means they are made the same way as brand-name drugs and have the same effect. Most generic drugs cost less. Presbyterian has a team that reviews the drugs on the Formulary to make sure they are safe and effective. Both pharmacists and doctors are on this team. They also decide if drugs should be added or removed from the Formulary. We want you to have the right prescription drugs to improve your health, even if these prescription drugs are not on our drug list. You may need a drug that is not on the drug list. Or you may need a drug that is not approved to treat your condition. In these cases, you or your provider can call the PCSC to request an exception. Or your provider can send a request to Presbyterian Centennial Care for an exception. We will look at your request and give authorization if we decide that the non-formulary drug is medically necessary (needed) . We usually give approval for two reasons: ● ● Your provider finds that a similar drug(s) on our list is not as effective in improving your health. ● ● Your provider finds that a similar drug(s) on our list could be harmful to your health. Getting your prescription filled To avoid problems filling your prescriptions, always ask your provider to check our Formulary (drug list). ● ● If your provider prescribes a drug that is not on our drug list, your provider must have approval from Presbyterian Centennial Care before you can get Your prescription drug coverage 6

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