Pharmacy Coverage

Our members can count on us for prescription drug coverage. They get all the same drugs that Medical Assistance covers, plus some over-the-counter drugs and vitamins with a prescription. Some medications may require a copayment and, depending on your category of aid, limits may apply.

Pharmacy Resources for Members

The UPMC for You Pharmacy Formulary (Non-PDL) is a list of Food and Drug Administration (FDA) approved medications. This list was developed by UPMC for You doctors and pharmacists and includes the most commonly used drugs. Medications on the formulary (drug list) that are prescribed by a doctor are paid for by UPMC for You. The list does not include every medication a doctor might prescribe. The drugs on the formulary have been selected because they are safe, work well, and cost less than other drugs that have the same level of effectiveness.

• UPMC for You Formulary

Additional Resources

• Pennsylvania Department of Human Services Preferred Drug List (PDL)
• Direct Reimbursement (DMR) Claim Form
• View minutes from the most recent Pharmacy & Therapeutics Committee meeting

Your managed care plan may not cover all your health care expenses. Read your member handbook carefully to determine which health care services are covered.