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Drug Name Search

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By Therapeutic Class

St. Luke’s Health Plan Formulary- Employer Group and Individual Formulary

Welcome

St. Luke’s Health Plan covers both brand and generic medications approved by the Food and Drug Administration (FDA). The formulary is updated throughout the year.

What is a Formulary?

A formulary is a list of covered drugs which represents the prescription therapies believed to be a necessary part of a quality treatment program. We will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your plan documents.

How to Search For Drugs

  • Use the alphabetical list to search by the first letter of your medication.
  • Search by typing part of the generic (chemical) and brand (trade) names.
  • Search by selecting the therapeutic class of the medication you are looking for.

Legend

TIERING
  • T1
    - Generic
  • T2
    - Non-Preferred Generic
  • T3
    - Preferred Brand
  • T4
    - Non-Preferred Brand
  • T5
    - Specialty
  • NF
    - Non-Formulary
Edits
  • QL
    - Quantity Limit
  • PA
    - Prior Authorization
  • ST
    - Step Therapy
  • AL1
    - Age Limit
  • S
    - Specialty Drug
  • QLC
    - Quantity Limit (Custom)
  • STC
    - C3
  • ACA
    - Affordable Care Act Medications
  • PV
    - Preventive
† Denotes brand name drug, otherwise generic drug
Brand Names
generic names