Formulary

Use our formulary (En Español) (list of covered prescription drugs) to see what generic and brand-name drugs are covered under our plans that have prescription drug coverage. If you do not see the drug you are looking for in the formulary, please call our pharmacy customer service. We may cover that drug. You can also contact pharmacy customer service to request a printed copy of the formulary.

Contact

Please call our Moda Health Customer Service at 503-265-4709 or toll-free at 888-786-7509. TTY users, dial 711. Customer Service is available to help you from 7 a.m. to 8 p.m., Monday through Friday. Weekend calls are forwarded to voicemail and returned the next day. 

Formulary updates

We may make changes to the formulary. Changes include:

  • Adding or removing drugs. This happens if a drug is recalled or not working, or a new drug becomes available
  • Moving a drug to a higher or lower cost-sharing tier
  • Adding or removing a restriction on coverage
  • Replacing a brand-name drug with a generic drug

If we make changes to a drug you are taking, we will send you a notice.

Making an exception

We may be able to cover a drug for you if you ask us to make an exception. You can request an exception if:

  • Your Part D-eligible drug is not on our formulary
  • We ask you to try another drug before you receive a drug you have requested
  • We limit the quantity or dose of a drug you have requested

To request an exception, you or your provider may do one of the following:

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Last updated Sep. 26, 2018
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