Horizon is constantly looking for ways to navigate managing costs especially in these trying times with inflation on the rise. For this reason, Horizon updated its list of formulary and non-formulary drug list that will help drive utilization toward safe, effective and less-costly medicines.
This new update applies to Individual, Small Group and Midsize Fully Insured (Excluding Public Sector) and Level Funded Markets.
What is a formulary?
Formulary’s are determined by a pharmacy and therapeutics committee. P&T committees are primary care and specialty physicians, pharmacists and other professionals in the health care field. Formulary changes typically occur twice a year.
Medicines that are now going to be a non-formulary status will remain eligible for coverage under the members’ pharmacy benefits at the same level as formulary medicines, if medically necessary. Members who are affected and their doctors have been notified as to which formulary alternatives are available.
Next Steps for Impacted Members
For further questions, or if you need information about formulary alternatives or need help with requesting a formulary exception, you can call Horizon Pharmacy Member Services at 1-800-370-5088 24/7.
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