Covered medications - online drug formulary
Choose whether you have a Medicare individual plan or a group plan. Choose “individual” if you have enrolled in Fallon Senior Plan HMO directly through Fallon Community Health Plan or if you are a prospect. Choose “group” if you receive your benefits through your or your spouse’s current or former employer.
Download printable versions of the formularies
Individual
Group
Please note: This represents our Medicare formularies. These printable formularies were last updated on August 1, 2011. They are subject to change at any time.
Prior authorization and step therapy
Prior authorization Fallon Community Health Plan (FCHP) requires your physician to get prior authorization for certain drugs. This means that you will need to get approval from FCHP before you fill your prescriptions. If you don’t get approval, Fallon Senior Plan may not cover the drug. If a drug requires a prior authorization, you'll see a "PA" next to the drug in the online drug formulary search. You can click on the "PA" symbol to see the prior authorization criteria for that medication.
Step therapy In some cases, FCHP 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, Fallon Senior Plan may not cover Drug B unless you try Drug A first. If Drug A does not work for you, Fallon Senior Plan will then cover Drug B.
Drugs with step therapy requirements:
Formulary changes
You may view the PDF documents below to see if there are changes to the Fallon Senior Plan formularies. If there are no documents listed below, then there are currently no changes to the list of covered medications.
H9001_2012_720_18_r3 CMS Approved 01042012
The information on this page was last updated on 12/13/2011.
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