Why aren’t all drugs covered by insurance? A formulary is the list of prescription medications covered by a health insurance plan. The list typically has brand-name and generic options. In addition to ...

As the Centers for Medicare & Medicaid Services adjust regulations for the upcoming fiscal cycle, beneficiaries face a ...

When the user enters a drug into the text box and clicks search, the system searches the current formulary first (brand and generic names). If a match is found for a particular medication, the salt ...

Optum Rx, the pharmacy benefits manager operated by healthcare behemoth UnitedHealth, is moving eight popular insulin products to preferred status on its standard formulary for commercially insured ...

Successful formulary system management can help ACOs achieve high quality, low cost objectives across the care continuum. This article targets healthcare leaders choosing to participate in the ...

With appreciation for feedback from Mark Fendrick, Director of the Value-Based Insurance Design (V-BID) Center at the University of Michigan, and Daneen Seekoni, Vice President of Policy and Advocacy ...

Starting Jan. 1, 2025, millions of Americans who get their prescription drugs through Medicare could get a major financial break when a $2,000 out-of-pocket spending cap on medications goes into ...

According to a Medicare Advantage literacy survey, three out of every four Medicare beneficiaries find the program confusing and hard to understand. This confusion can lead to a lack of proper ...

When considering a Medicare Part D plan, it's essential to understand the cost parameters set by the Centers for Medicare and Medicaid Services (CMS). For 2026, the maximum deductible for Part D plans ...

Are Weight Loss Drugs Covered By Insurance? This article was reviewed by Craig Primack, MD, FACP, FAAP, FOMA. If you’re considering using medication to reach a healthy body weight, your first question ...