The HMSA drug formulary is a list of prescription drugs, both generic and brand name, that are covered under your drug plan. Choosing drugs that are listed on the formulary can help you save money on your drug copayments. To help you determine what your out-of-pocket cost will be, please read Drug categories.
Please note that the formulary is designed to be as comprehensive as possible, but doesn’t list all drugs currently available.
How drugs are added to the formulary?
HMSA has an advisory committee that meets quarterly to review the drugs on the formulary and add new ones. Drugs that meet the committee’s standards for safety, efficacy, ease of use, and value are added to the formulary.
What if I’m taking more than one drug for my condition?
If you’re on two or more medications for chronic conditions, you may qualify for medication synchronization*. In medication synchronization, a pharmacist coordinates the refill of your maintenance prescription drugs so you can pick them up on a single day each month. Please read the Medication Synchronization policy to learn more about the criteria/guidelines, limitations, and exclusions.
*Doesn’t apply to Medicare programs or Fed87 plan.
Find your plan's drug formulary
HMSA Medicare Advantage Plans
HMSA QUEST Integration
All other types of HMSA plans
If you don't have a Medicare or QUEST Integration plan, you probably have a plan through your employer or a plan that you purchased on your own, such as an Affordable Care Act plan.
Here's how to find out which formulary to use with your plan:
Find your plan’s drug code on your HMSA membership card next to the word DRUG. If there’s no drug code, you may not have drug coverage through HMSA.
Log in to My Account and download your plan's formulary. Or use the Check Drug Cost tool to find out if your medication is covered and what your copayment will be. We'll show you lower-cost options, if available.
Not registered for My Account? Register and link your plan. It takes just a few minutes. Here’s what you can do.
You can also call CVS Caremark®, our pharmacy benefits manager, to find out which formulary your plan uses. Call 1 (855) 298-2491 toll-free.