Every insurance plan has a list of drugs that have a proven record of clinical effectiveness and affordability. This list is called the Formulary.

If you medication is not on the formulary, you will need to ask your doctor to pre-authorize the medication and provide a reason to the insurance company why you will need this more expensive non-formulary medication instead of the less expensive formulary medication. This is a routine phone call for the doctor’s office staff.

If approved, the insurance plan will cover that medication.

Here is how to see the Formulary

Anthem Blue Cross

Blue Shield of California

Note: It is a good practice to log onto the insurance company website using your username and password and doing a prescription search that will be specific for your plan.