Covered medications—online drug formulary
Search for a medication in our online formulary tool
Choose a formulary:
Download a printable formulary
Fallon Health Formulary (pdf, last updated: 10/28/2024)
Or: Request a printed formulary.
Find a pharmacy
We have over 67,000 pharmacies in our pharmacy network.
Find a pharmacy
Part B step therapy
In some cases, Fallon Health requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, your plan may not cover Drug B unless you try Drug A first. If Drug A does not work for you, your plan will then cover Drug B. Step Therapy may be required for the medications listed in the table below.
- Abraxane
- Aloxi
- Asceniv/Alyglo
- Avastin/Alymsys/Vegzelma/
Avzivi/Bendamustine
- Beovu
- Cimerli
- Durolane/Gel-One/GelSyn3/
GenVisc 850/Hyalgan/
Hymovis/Monovisc/
Orthovisc/sodium hyaluronate/
Supartz/Supartz FX/
Synojoynt
- Eylea/Eylea HD
- Fusilev/Khapzory
- Herceptin Hylecta
- Herceptin/Ontruzant/Herzuma/
Ogivri/Hercessi
- HP Acthar
- Lucentis/Byooviz
- Macugen
- Neupogen
|
- Pemfexy
- Procrit/Epogen (non-ESRD)
- Prolia/Xgeva
- Purified Cortrophin Gel Remicade/Avsola/Renflexis/infliximab
- Releuko/Granix/Nivestym
- Rituxan Hyleca
- Rituxan/Riabni/Ruxience
- Rolvedon
- Ryzneuta
- Soliris
- Sustol
- Susvimo
- Treanda/Vivimusta
- Trivisc/VISCO-3/Triluron
- Udenyca/Ziextenzo/Nyvepria/ Stimufend/Fylnetra
- Ultomiris
- Vabysmo
- Zilretta
|
Call us toll-free at 1-888-340-5504 (TRS 711), 8 a.m.–8 p.m., seven days a week.
(Apr.–Sept., we are available 8 a.m.–8 p.m., Mon.–Fri.)
H9001_240093_C | The information on this page was last updated on 10/1/2023.