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HEALTH PLUS FORMULARY AND PHARMACY BENEFIT INFORMATION


Health Plus covers pharmacy benefits for Child Health Plus (CHP) and Health Plus Elite (Medicare Advantage) members. For CHP members, Health Plus uses the ChoiceTM Formulary. For Health Plus Elite members, there is a separate formulary for drugs covered under Medicare Part D. Both formularies include all covered outpatient prescription drugs and describe the prior authorization, step therapy and quantity limit requirements for certain classes of medication. Copies of both the Choice and Part D formularies can be found below. For more information, please contact MedImpact (the Health Plus Pharmacy Benefit Manager) at 1-800-788-2949 or visit http://www.medimpact.com/. The Medication Request Form (MRF) to be used when requesting authorization for non-formulary drugs is included below for your convenience. For Health Care Plus (Medicaid) and Family Health Plus (FHP) members, information on NYS Medicaid formulary requirements also appears below.

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