Formularios

We update our online formularies regularly.

You can search by drug name or category and download as a PDF.

Formulario de 2025

Plans	Online Link	Versión en PDF	Comentarios
Jefferson Health Plans Medicare Advantage Premium Formulary: Special, Dual Pearl	Buscar en línea	Descargar Updated 1/1/2025
Jefferson Health Plans Medicare Advantage Core Formulary:  Prime, Complete, Silver, Platinum, Flex Plus, Flex Pro	Buscar en línea	Descargar Updated 1/1/2025
Jefferson Health Plans Medicare Advantage Value Formulary: Giveback, Flex, Choice, Choice Plus	Buscar en línea	Descargar Updated 1/1/2025
Health Partners Plans Medicaid PDL and Supplemental Formulary	Buscar en línea	Descargar
CHIP	Buscar en línea	Descargar Updated 01/2025
Jefferson Health Plans Individual and Family Plans	Buscar en línea	Descargar Updated 1/2025	Historial de modificaciones (Updated December 2024)

Formulario de 2024

Plans	Online Link	Versión en PDF	Comentarios
Jefferson Health Plans Medicare Advantage Pennsylvania: HMO-POS & PPO Prime (HMO-POS) Complete (HMO-POS)  Giveback (HMO-POS)  Flex (PPO)  Flex Plus (PPO)  New Jersey: HMO-POS  Silver (HMO-POS)  Platinum (HMO-POS)	Buscar en línea	Descargar Actualizado el 12/1/2024	Historial de modificaciones (Updated December 2024)
Jefferson Health Plans Medicare Advantage Pennsylvania: D-SNP  Special (HMO SNP) Dual Pearl (HMO SNP)	Buscar en línea	Descargar Actualizado el 12/1/2024	Historial de modificaciones (Updated December 2024)
Health Partners Plans Medicaid PDL and Supplemental Formulary	Buscar en línea	Descargar
CHIP	Buscar en línea	Descargar Updated 10/2024
Jefferson Health Plans Individual and Family Plans	Buscar en línea	Descargar Updated 9/2024	Historial de modificaciones (Updated December 2024)

Recursos adicionales

P&T Committee

The Pharmacy and Therapeutics (P&T) Committee has reviewed and approved the formularies. Review the most recent P&T Committee meeting summary minutes:

Autorización previa

Click here to request drugs requiring prior authorization or non-formulary drugs

Printed Formularies

Call the Provider Services Helpline at  1-888-991-9023 to request a printed copy of our formularies.

Health Partners (Medicaid), CHIP and Jefferson Health Plans IFP Formulary Updates

Throughout the year, Jefferson Health Plans makes changes to our formularies. Use the links below to see the most recent updates to formularies, prior authorization requirements, quantity limits, age edits and more.

Preguntas frecuentes

We offer 90-day prescriptions for inexpensive, chronic medications for all members. However, we encourage 100-day prescriptions for Medicare members who have chronic conditions. Our members usually can save time and money with extended day prescriptions, which can impact compliance with their medication regimen. Special pricing is available through network pharmacies and our mail order program. Note: extended day supplies are not available for specialty drugs.

A drug recall list can be found on the FDA's website. Any members affected will receive a drug recall from Jefferson Health Plans.

Please submit these requests in writing to the pharmacy department. Requests for additions to the formulary will be reviewed by the P&T Committee.

Formularios

Contents:

We update our online formularies regularly.

Formulario de 2025

Formulario de 2024

Recursos adicionales

Do you offer extended day supplies for prescriptions?

Where can I find drug recalls?

Where can I make a suggestion for additions to the formulary?