Preferred Medication List (PML) / Formulary

The PML or Formulary details:

• Which medications are covered
• What copayment or coinsurance level applies
  • Highest out-of-pocket costs for members occur when a prescription is written and filled for a medication not on the PML
• The PML is a list of prescription medications that are encouraged by RegenceRx, based on:
  • Value
  • Effectiveness
  • Scientific evaluation of their safety
  • Overall impact on health outcomes
• View the current PML

Selection of PML/Formulary Medications

Before a medication is added to our PML, RegenceRx pharmacists:

• Research scientific and evidence based data
• Perform an extensive evaluation
• Give recommendations to an independent committee of physicians and pharmacists who make the final formulary decisions

The PML is updated throughout the year to reflect new medications available on the market. At least one or more medications are available on the PML for each condition that is a covered benefit. 

Non-Formulary Medications

• Any medication not listed on the PML is non-formulary
• If your patient has a closed formulary benefit, non-formulary medications are only available at the member’s expense
• If your patient has a three-tier prescription benefit, non-formulary medications are only available at the highest copayment