Select Drug Formulary - AmeriHealth

Select Drug Program FormularyeFFective January 1, 2022 FOR MEMBERS AND PROVIDERSThis Select Drug Program Formulary is intended to help members and providers understand prescription drug coverage under the AmeriHealth Select Drug Program Formulary . We are committed to providing comprehensive prescription drug coverage. To achieve this, we include a Formulary feature in your prescription drug benefit. The drugs are approved by the Food and Drug Administration (FDA). They are also reviewed by our Pharmacy and Therapeutics Committee, a group of doctors and pharmacists from the area. These prescription drugs have been added to the Select Drug Program Formulary for their reported medical effectiveness, safety, and , an independent company, is our pharmacy benefits manager. They monitor all drugs to ensure they are safe and effective note: Prescription drug benefits vary by group. Therefore, a drug on this Formulary does not imply coverage. Drug coverage is based on medical necessity.

Bowel Preparations Bowel preparation for colonoscopy needed for preventive colon cancer screening, for ages 45-75 generic bowel preparation products such as Gavilyte-C™, Gavilyte-G™, Gavilyte-N™, Gavilyte-H™ with bisacodyl, polyethylene glycol (PEG) 3350 oral powder, Trilyte® w/packets Breast cancer chemo prevention

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  Preparation, Below, Colonoscopy, Amerihealth, Bowel preparation

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