Formularies

Health Partners (Medicaid): Effective January 1, 2020, the Department of Human Services (DHS) is implementing a Preferred Drug List (PDL) for all Pennsylvania Medical Assistance members. Click here to access the statewide PDL.

2024 Formularies

• Online formularies can be searched by drug name or category.
• The formularies can be downloaded as a PDF.
• Formularies are updated regularly.

Formulary

Online Link

PDF Version

Comments

Individual and Family Plans

Medicare

Medicare

Additional formulary information:

• How to request drugs requiring prior authorization or non-Formulary drugs
• Review the most recent P&T Committee meeting summary minutes:
  • Medicaid (October 2023)
  • Medicare (October 2023)
  • Individual and Family Plans (July 2024)

  The Health Partners Plans Pharmacy and Therapeutics (P&T) Committee has reviewed and approved the Health Partners (Medicaid), KidzPartners (CHIP) and Health Partners Medicare formularies.

  Printed Formularies

  Call our Provider Services Helpline at 1-888-991-9023 to request a printed copy of our formularies.

  Updates

  Throughout the year, we may make changes to our formularies. Use the links below to see the most recent updates to formularies, prior authorization requirements, quantity limits, age edits, and more.

  Health Partners (Medicaid):

  • Medicaid Formulary Changes #174 (updated August 2024)
  • Medicaid Formulary Changes #168 (updated August 2023)
  • Medicaid Formulary Changes #169 (updated October 2023)
  • Medicaid Formulary Changes #170 (updated January 2024)
  • Medicaid Formulary Changes #171 (updated February 2024)
  • Medicaid Formulary Changes #172 (updated April 2024)
  • Medicaid Formulary Changes #173 (updated July 2024)
  • Medicaid Formulary Changes #174 (updated August 2024)

  Up to 100-day Prescription Supply

  We offer 90-day prescriptions (100-day for Medicare members) for inexpensive, chronic medications for all members. We encourage 100-day prescriptions for our Medicare members who have chronic conditions. Our members usually can save time and money with extended day prescriptions, which can impact compliance with their medication regimen. Special pricing is available through network pharmacies and our mail order program. Note: Up to 100-day supplies are not available for specialty drugs.

  Drug Recalls

  A drug recall list can be found on the FDA's website. Any members affected will receive a drug recall from HPP.

  Suggestions or Questions?

  Please call the Pharmacy department at 215-991-4300 with questions or feedback. If you have suggestions for additions to the formulary, please submit these requests in writing to the pharmacy department. Requests for additions to the formulary will be reviewed by the P&T Committee.

  Health Partners Plans will continue to update its formularies regularly and communicate the changes to you in a timely manner.