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Value formulary

The Value formulary is designed to include all therapeutic categories and provide physicians with prescribing options. In addition, the formulary is reviewed periodically to add new drugs and to remove brand drugs when a generic equivalent becomes available. When a generic equivalent becomes available, the brand drug may be subject to a change in cost share. Drugs not found on the formulary are only covered when a medical necessity request is approved.

When you prescribe a formulary medication, AmeriHealth members receive the drug for a lower out-of-pocket cost share. If you prescribe a drug not on the formulary (non-formulary), you must submit a medical necessity request. Instructions can be found on the prior authorization page.

New Jersey