The Allegian Choice formulary is a complete list of medications offered by your plan. Allegian Choice covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. Providers’ use of the Allegian Choice Drug Formulary ensures our members' pharmaceutical needs are met in a high quality, cost-effective manner.
The formulary is subject to change during the year. To review the Allegian Choice formulary, use the links below.
2017 Allegian Choice Formulary (Effective 5/1/17)
Some drugs have limits on coverage such as quantity limits, medications requiring the submission of a prior authorization (PA) request or step therapy (ST) where an alternative medication must be tried before granting coverage of the requested drug. The 2 letter abbreviation indicates a limitation and appears in the last column of the formulary. The abbreviation key is on the bottom of each page of the formulary. If a medication requires a PA, the prescriber must submit the PA form to the pharmacy benefit manager, CVS/caremark™. To request an exception, or to request a PA for a medication, your doctor can submit a PA online or fax a PA form along with a written statement supporting the request to 855-836- 0730 or call 855-582-2022.
After coverage begins, members may learn more about their pharmacy benefit at www.caremark.com/startnow.
Allegian Health Plans' Allegian Choice 2017 Gold plan is not subject to subsidies you may be eligible for when shopping for plans on the Health Insurance Marketplace/Exchange.
GETTING YOUR PRESCRIPTIONS
The Pharmacy Directory contains a list of network pharmacies. The pharmacies are called network pharmacies because they have contractual arrangements with our pharmacy benefit manager CVS/caremark™ to provide prescriptions to our members. To view the Pharmacy Directory, click the link below to go to the Find a Provider/Pharmacy page.
Choose one of three easy ways to start using the CVS/caremark™ Mail Service Pharmacy:
- Fill out and send in a mail service order form
- Visit www.caremark.com/faststart
- Call FastStart toll free at 1-800-875-0867
Specialty medications are available only through CVS/caremark™ Specialty Pharmacy. The pharmacists are available by phone 24 hours a day, 365 days a year to answer questions about specialty medicine and your health. Call the Specialty Customer Care Team toll-free number, 1-800-237-2767 or visit www.CVSCaremarkSpecialtyRX.com for information.