Drug Formularies
Is your prescription covered under your plan? The Formulary Search Tool can give you the answers you need.
The Martin’s Point US Family Health Plan uses a prescription drug formulary—a list of covered drugs that have been selected in consultation with a team of health care providers.
The USFHP plan formularies represent the prescription therapies believed to be a necessary part of a quality treatment program.
Below you will find information relating to your plan's prescription drug formulary as well as other important information.d
Table of Contents:
2024 Drug Formularies
Martin’s Point US Family Health Plan will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at one of our network pharmacies, and other related plan rules are followed.
Generally, we only cover drugs filled at an out-of-network pharmacy in limited, non-routine circumstances when a network pharmacy is not available.
LOOKING FOR A SPECIFIC DRUG?
USE THE FORMULARY SEARCH TOOL
US Family Health Plan members can use the online Formulary Search Tool to find detailed coverage information for a specific prescription drug here:
Drug Formulary Search Tips
Helpful tips and step-by-step instructions for searching the formulary for a specific prescription drug can be found here:d
FORMULARY SEARCH: A STEP-BY-STEP GUIDE |
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STEP 1: Enter name of medication into the box. STEP 2: Wait for a list to appear. This list will contain all the covered strengths for the drug. STEP 3: Choose the strength you want and press enter. |
STEP 4: A page will present the following:
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If the medication you are searching for is not covered by the benefit, this message will appear near where the cost/copay information is located: “Non-formulary." For additional guidance, download the comprehensive Formulary Search Tool User Guide. |
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Formulary Changes & FDA Drug Recalls
The latest information and documents regarding plan drug formulary changes and FDA drug recalls can be found here:
The formulary is updated on a regular basis to include tier changes and utilization (UM) requirements. A formulary may change during the year if we remove drugs from our formulary, add a prior authorization requirement, add quantity limits and/or step therapy restrictions on a drug, and/or move a drug to a higher cost-sharing tier.
We must notify you at least 30 days before any of these changes become effective. At the time you request a refill, you will receive a 30-day supply of the drug.
The table below outlines changes to the TRICARE formulary applicable to Martin’s Point USFHP since 1/1/2024.
QL= Quantity Limit | PA=Prior Authorization | ST=Step Therapy
Stay informed with the latest FDA recalls and safety alerts affecting your medications and health devices. Understanding these updates ensures your health and safety by avoiding affected products.
Not all recalls are announced on FDA.gov or in the news media. Public notification is generally issued when a product that has been widely distributed or poses a serious health hazard is recalled. However, if a company does not issue public notification of a recall, FDA may do so if the agency determines it is necessary to protect patients and consumers. Patients and consumers also may learn that their medicine has been recalled through notification from the manufacturer, their doctor or pharmacist.
FDA recommends patients talk to their health care professional about the best course of action for their health if they have a medication that has been recalled.
All information regarding FDA recalls can be found here: