Many prescription drugs are covered by PrimaryHealth. PrimaryHealth does not charge any copays for medications. Prescription drugs treating covered conditions are a benefit under the OHP. Not all medications are covered under the PrimaryHealth drug coverage plan. Please contact the PrimaryHealth office if you have any questions about prescription medications or if you need help getting a drug not covered by PrimaryHealth, or if you need prior approval.
PrimaryHealth has a list of medications (called the “formulary”) that are covered by PrimaryHealth. Call us or visit our website if you would like a copy of our current list. Listed medications are used because they are effective in treating your condition and cost less. PrimaryHealth may add or remove drugs or change coverage requirements on drugs. If we remove a drug from the list or add restriction to a drug that you are taking, we will tell you in advance. PrimaryHealth does not pay for drugs that are not on our list, or drugs that have been removed from our list. If your doctor orders a medication for you that is not on the PrimaryHealth list, we will ask your doctor to choose a medication from the list. Contact your PCP to talk about your choices. If your PCP thinks there is a reason that a listed drug is not safe or effective for you, PrimaryHealth may give you an exception.
For questions about our formulary or coverage for your prescription please contact PrimaryHealth.
Toll Free: 1-800-471-0304