2020 Formulary

2020 Formulary.

The formulary is a list of covered drugs. Community Health Choice (HMO D-SNP) will generally cover any prescription drug listed in our formulary as long as:

  • the drug is medically necessary
  • the prescription is filled at a network pharmacy
  • all other plan rules are followed

Changes to the Formulary

We may add or remove drugs from the formulary during the plan year. If we remove drugs from the formulary or add prior authorizations, quantity limits, and/or step therapy restrictions on a drug, and you are taking the drug affected by the change, we will notify you of the change at least 60 days before the date the change becomes effective. However, if a drug is removed from our formulary because the drug has been recalled from the market, we will not give 60 days notice before removing the drug from the formulary. Instead, we will remove the drug from our formulary immediately and notify members about the change as soon as possible. For more information on covered drugs and how to fill your prescriptions, including obtaining prescriptions at out-of-network pharmacies and how to get a temporary supply of drugs as a new member, see our Transition Policy.

Generic Drugs

Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.


2020 (Formulary)– Version en Español 

H9826_IT_10045_092919_M Last updated August 18, 2020.