Get Nonformulary Phoenix

If a medication is “non-formulary,” it means it is not included on the insurance company's “formulary” or list of covered medications. A medication may not be on the formulary because an alternative is proven to be just as effective and safe but less costly.

The most commonly prescribed classes of non-formulary drugs were immunobiologicals (vaccines), antiemetics, vitamins, psychotropic drugs, beta blockers, and systemic antimycotics and antibacterials.

Tier 3 - Nonpreferred Brand: Tier 3 is made up of nonpreferred, brand-name drugs that do have a generic option. Since there are more cost-effective alternatives available for these drugs, you'll have the highest copayment or these drugs may not be covered.

Level or Tier 1: Low-cost generic and brand-name drugs. Level or Tier 2: Higher-cost generic and brand-name drugs. Level or Tier 3: High-cost, mostly brand-name drugs that may have generic or brand-name alternatives in Levels 1 or 2. Level or Tier 4: Highest-cost, mostly brand-name drugs.

If a medication is “non-formulary,” it means it is not included on the insurance company's “formulary” or list of covered medications. A medication may not be on the formulary because an alternative is proven to be just as effective and safe but less costly.

A tiered formulary divides drugs into groups based mostly on cost....What is a tiered formulary? Drug tierType of drugs includedYour costTier 1Most generic drugsLowest copayTier 2Most common brand name drugs Preferred brand name drugs Some high-cost generic drugsMedium copayTier 3Non-preferred brand name drugsHighest copay1 more row

A formulary is a list of generic and brand name prescription drugs covered by your health plan. Non-formulary drugs typically only include brand-name medications and come with high out-of-pocket expenses. Your health plan may only help you pay for the drugs listed on its formulary.

Tier 3—Non-preferred, brand-name prescription drugs. Higher copayment. Specialty tier—Very high cost prescription drugs. Highest copayment or coinsurance.