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Prescription Drug Formulary

The prescription drug formulary is designed to include all therapeutic categories and provide physicians with prescribing options. Drugs on the formulary are chosen for their reported medical effectiveness, positive results, and value. The formulary is reviewed periodically to add new drugs and to remove brand-name drugs when a generic equivalent becomes available.

Premium Formulary

The drugs on the Premium Formulary have been selected for their clinical effectiveness, safety, and savings. The Premium Formulary is intended to help maintain affordable medication access and promote the use of lower-cost alternatives.

The Premium Formulary differs from the standard drug formulary in that it excludes 80 medications, which all have clinical alternatives included in the Premium Formulary.

To help your patients who use the Premium Formulary make the most of their health care dollars, please consider if a drug is included or if a generic equivalent or similar drug is available before prescribing it.

The Premium Formulary is managed and maintained by FutureScripts. Independence Administrators does not control how the Premium Formulary is comprised or administered.

Submit a Prior Authorization Request for Determination

Prior authorization requests for Independence Administrators plan members must be submitted directly to FutureScripts®, our pharmacy benefits manager.

Please visit FutureScripts to download the applicable request form and fax it to 215-241-3073 (local) or 1-888-671-5285 (toll-free). You can also call FutureScripts directly at 1-888-678-7013.

Effective Use of the Formulary

When you prescribe a formulary medication for members enrolled in a formulary program, they can purchase the drug at a lower copayment. If you prescribe a drug not on the formulary, the member’s out-of-pocket cost will be greater.

The use of the formulary does not prohibit you from prescribing a covered medication. You may prescribe any covered medication, regardless of whether the drug is on the formulary or not.

Before prescribing a medication to a member, you should work with that member to determine if the drug is included on the formulary. If a member is currently taking a drug that does not appear on the formulary, you may be able to change the prescription to a similar drug that is on the formulary.