Sharp Health Plan 2020 Formulary List of Covered Prescription Drugs
2020 Formulary List of covered prescription drugs This drug list applies to all Large Group HMO and Large Group POS products, and the following Small Group HMO products: HMO GF 1, HMO GF 2, HMO GF 3, HMO GF 4, HMO GF 5, HMO GF 6, HMO GF 7, Bronze HDHP NG 1, CalChoice Bronze HDHP NG 3, CalChoice Bronze HMO NG 2, CalChoice Silver HMO NG 1, CalChoice Silver HMO NG 2, CalChoice Silver HMO NG 3, Silver HMO NG 1, Silver HMO NG 2, CalChoice Gold HMO NG 2, CalChoice Gold HMO NG 3, CalChoice Gold HMO NG 5, Gold HMO NG 1, Gold HMO NG 2, Gold HMO NG 3, Gold HMO NG 4, Gold HMO NG 5, Gold HMO NG 6, Gold HMO NG 7, CalChoice Platinum HMO NG 1, CalChoice Platinum HMO NG 2, CalChoice Platinum HMO NG 3, Platinum HMO NG 1, Platinum HMO NG 2, Platinum HMO NG 3, Platinum HMO NG 4, Platinum HMO NG 7, Platinum HMO NG 8 List of covered prescription drugs for Employer-sponsored plans from Sharp Health Plan An electronic version of this Prescription Drug List is available on the Sharp Health Plan website, by visiting sharphealthplan.com/search-drug-list You can find specific cost sharing information in your plan’s coverage documents by logging in to your Sharp Connect account on our website by visiting sharphealthplan.com/login This document is subject to change and all previous versions are no longer in effect. Last updated 12/01/2020. Table of Contents Introduction i-xii Definitions i How often does the Formulary change? iii Will I be notified of a Formulary change? iii How do I locate a Prescription Drug on the Formulary? iv How do I know if the drug listed
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