Benefits Education

What Is a Drug Formulary, and How Do I Find My Medications?

A formulary is the list of prescription drugs your plan covers, organized to show which medications are included and any limits that apply. To find out whether a specific medication is covered under your LifeX group health benefits, you'll check the formulary that matches your plan and your pharmacy benefit manager, ProAct.

How formularies work

Not every plan uses the same drug list. Which formulary applies to you depends on the plan you're enrolled in:

  • MM and HSA plans use the full Advantage Formulary.
  • VL plans use the VL Formulary.
  • All members can reference the Telehealth and Mail Order Formulary for those channels.

There's also a Pharmacy Exclusions list, which shows medications that aren't covered. Checking both the formulary and the exclusions gives you the complete picture for a given drug.

Who manages the pharmacy benefit

ProAct is the pharmacy benefit manager (PBM) for LifeX. They administer the drug benefit, and their help desk can answer questions about coverage, pricing tiers, and limits on specific medications. For specialty medications—which often cost more and require extra coordination—Noble Health Services handles fulfillment and patient support, and begins working with a member as soon as they receive a prescription.

How to check a specific medication

  1. Identify which plan you're on (MM, HSA, or VL), since that determines your formulary.
  2. Open the formulary that matches your plan and search for the medication.
  3. Check the Pharmacy Exclusions list to confirm the drug isn't excluded.
  4. If you're unsure about limits or tiers, contact ProAct's help desk for specifics.

The formulary links and ProAct's contact information are provided in your enrollment materials and your Employee Wellness Hub.

The bottom line

Your formulary tells you which prescriptions are covered and under what conditions, and the right formulary depends on your specific plan. When in doubt about a particular medication, check the formulary and exclusions list, then confirm with ProAct.

This article explains how prescription drug coverage is organized and is not a description of any specific plan's benefits. For what your plan covers, see your formulary, Summary of Benefits and Coverage, and plan documents.