The medications included on your insurance plan’s formulary are determined by the health plan, not your provider (including those at Alpha Medical) or your pharmacy. To find out if your insurance will cover medications their formulary doesn’t include, please get in touch with your insurance company’s customer services department. Ask them what procedures or options are available if their formulary doesn’t include certain medications.
When you contact your health insurance plan to request that they add a medication to your formulary, be sure to ask them questions like:
- How can I request coverage for a medication that is not listed on my formulary?
- What steps are there in this procedure, and how soon can I receive a determination?
- Does my health condition or diagnosis impact coverage or approval?
For certain types of conditions or medication, your provider and pharmacy team may be able to submit a prior authorization request.