Switch to:

Find a Doctor

Find a Doctor

Sign In

Sign In

$0 Premium Essential Plan

Help Renewing Your Plan

City of New York Employees
Switch to:

Search

Popular Tasks

Contact us

Neighborhood Care

Drugs Covered

Older man with beard talking to female pharmacist.

Which drugs are covered by my plan?

Looking for Medicare formularies? 

 

2025 Plan formularies

You can see the list of drugs covered by your EmblemHealth plan below. This drug list is also known as a formulary.  To find your plan’s formulary, simply locate the letter identifiers in the “Formulary” section on the front of your member ID card, which will match one of the options found in parenthesis below.

  • Formulary Changes

  • Essential Plan Formulary

    The list of drugs we cover under the Essential Plan for New York State of Health members. 

     Last Updated: 11/01/2024

  • Qualified Health Plan Formulary (QHP)

    The list of drugs we cover under the Qualified Health Plan for New York State of Health members.

     Last Updated: 11/01/2024

  • Small Group Formulary (SG)

    Last Updated: 11/01/2024

  • Large Group Formulary (LG)

    The list of drugs we cover under the large group formulary.

  • Large Group Legacy Formulary (LGL)

    The list of drugs we cover under the large group legacy formulary.

  • Child Health Plus Formulary

    The list of drugs we cover under the Child Health Plus formulary.

  • New York State Health Insurance Program - No Rx (HIP1T)

    The list of drugs we cover under the New York State Health Insurance Program (NYSHIP) 1 Tier/No Rx.

  • New York State Health Insurance Program - Rx (HIP2T)

    The list of drugs we cover under the New York State Health Insurance Program (NYSHIP) 2 Tier/Rx.
 

Plan formularies

You can see the list of drugs covered by your EmblemHealth plan below. This drug list is also known as a formulary.  To find your plan’s formulary, simply locate the letter identifiers in the “Formulary” section on the front of your member ID card, which will match one of the options found in parenthesis below.

  • 2024 Essential Plan Formulary

    The list of drugs we cover under the Essential Plan for New York State of Health members. 

     Last Updated: 11/01/2024

  • 2024 Qualified Health Plan Formulary (QHP)

    The list of drugs we cover under the Qualified Health Plan for New York State of Health members.

     Last Updated: 11/01/2024

  • 2024 Small Group Formulary (SG)

    Last Updated: 11/01/2024

  • 2024 Large Group Formulary (LG)

    The list of drugs we cover under the large group formulary.

     Last Updated: 10/01/2024

  • 2024 Large Group Legacy Formulary (LGL)

    The list of drugs we cover under the large group legacy formulary.

     Last Updated: 10/01/2024

  • 2024 Child Health Plus Formulary

    The list of drugs we cover under the Child Health Plus formulary.

     Last Updated: 10/01/2024

YOUR MEDICATION

Delivery and Refills

Find out how to set up home delivery or a get a prescription refill.

Female pharmacist smiling and putting hand on customer's shoulder.

MTM PROGRAM

Medication Therapy Management

Find out if you qualify for this service, which is free for EmblemHealth Medicare plan members with Part D prescription drug coverage.

Older man and woman looking at a tablet PC.

KNOW YOUR RIGHTS

Grievances and Appeals

Find out how to file a grievance or an appeal, request coverage decisions and determinations, and more.

If you are not sure which formulary your plan uses or have any other questions, call your employer’s benefit administrator or EmblemHealth Customer Service at the number on your member ID card.

HELP AND SUPPORT

Pharmacy Support

Search your plan formulary, find participating pharmacies, and access forms.

Pharmacist smiling at male customer.
Also of Interest: 
Pharmacy   |   Medicare Formularies   |   Delivery & Refills