Formulary Search Tool
Please note that this formulary does not guarantee coverage. Coverage will vary by plan design. Please refer to the plan documents provided by your employer, or contact SmithRx Member Support at (844) 454-5201 for the most accurate information about drug coverage.
Home Screen
This home screen is the first screen you will see of the formulary.
Hiding the Legend
To get a better view of the drug information, you may want to hide the legend. Click the highlighted down arrow to hide the Legend
Drug Search - Search Bar
- Using the search bar, select it and type in the name of a drug
- E.g., “venlafaxine”
- A list of drugs will appear below it. Select one of the options with your cursor by hovering over it and clicking
See the accompanying drug information appear on the right. This will include much helpful information like Drug Name, Tier, Edits and Alternatives.
How to Identify Alternatives
Your physician should be the one who ultimately decides which alternatives are clinically appropriate for you. However, this tool has the functionality to determine covered medications within the same therapeutic class which can be helpful to bring up to your physician. The formulary look-up tool can help provide medications that are similar to the drug you are searching in the tool.
Simply click “Find Alternative Drugs” to see a list of medications that are in the same drug class.
Formulary Status
There can be up to 5 tiers on your formulary, and they may not correspond to the tiering displayed below. Refer to your plan documents to determine the copay or coinsurance associated with each tier.
Formulary edits, e.g. quantity limits, prior authorization, high cost generic, may modify the coverage of a drug or indicate that the drug requires additional clinical review before coverage.
Contact SmithRx Member Support at (844) 454-5201 if you are unsure how to interpret the results of your drug search.
Formulary Edits
Formulary edits can change the tier, coverage or add utilization management (e.g. quantity limits, age edits, etc) for a drug.
Type | Abbreviation | Description |
Quantity Limit | QL | There is a limit on the amount of this drug that is covered per prescription, or within a specific time frame. |
Step Therapy | ST | In some cases, you may be required to first try certain drugs to treat your medical condition before we will cover another drug for that condition. |
Age Limit | AL1 | This prescription drug may only be covered if you meet the minimum or maximum age limit. |
Medical Drug | MED | These products may be available through your medical benefit. Medical products include medical devices and medications administered by a healthcare provider or used during a medical procedure. |
Non-Essential Generic | NEG | Exclusion of high cost generics drugs with clinically equivalent alternatives |
Multisource Brand | MSB | Exclusion of branded products with direct generic alternatives |
Preventative | PREV | These medications prevent the development or worsening of select medical conditions, including osteoporosis, diabetes, asthma, depression, etc. |
Prior Authorization | PA | You (or your physician) are required to get prior authorization before you fill your prescription for this drug. Without prior approval, we may not cover this drug. |
Gender Limit | GL | This prescription drug may only be covered for a single gender. |
Specialty Drug | S | Specialty drugs are high-cost drugs used to treat complex or rare conditions, such as multiple sclerosis, rheumatoid arthritis, hepatitis C, and hemophilia. |
Affordable Care Act | ACA | This product is covered at $0 under the Affordable Care Act. |
Non-Essential Brand | NEB | Exclusion of high cost brand drugs with clinically equivalent alternatives |
High Cost Generic | HCG | Exclusion or uptiering generic medications with lower cost alternatives |
Click on the edit in the legend located on the bottom of the screen for a more detailed description.
Drug Search - Therapeutic Class
- Drugs are listed by therapeutic class in the “By Therapeutic Class” section
- Scroll through this menu and click on the relevant therapeutic class
- The class’s formulary information will appear on the right