BMC HealthNet Plan Formulary Welcome to the BMC HealthNet Plan Formulary, your online search tool for prescription drug coverage. If you have questions about drug coverage, or would like to request a printed version of the formulary, please contact us at the listed phone number or email. I would like to search the formulary: 1. Choose the member's plan type 2. Type the name of the drug (minimum of 3 letters) or choose a drug category 3. Click on Search Formulary Plan Type: Select Plan Type... BMC COMM CARE II, III BMC EmpChoice/CommChoice BMC MassHealth CommCare 1 Drug Name: Drug Category: All Drug Categories Drug Tier: All Drug Tiers • Know the copayment tier information. • View covered over-the-counter products. • Understand the coverage comments, learn about the criteria, or download the PA request form. Coverage / Comments Pharmacy Program Covered The drug is covered Mandatory Generic Mandatory Generic Program (the generic drug is covered) ST Step Therapy Program QL Quantity Limitation Program PA Prior Authorization Program DE The drug is excluded from coverage Specialty Pharmacy The drug must be ordered through specialty pharmacy New-to-Market New-to-Market Program - requires prior authorization Please note: The BMC HealthNet Plan Formulary represents outpatient medications that are normally filled at retail pharmacies. Medications given by a health care professional in a health care setting are not listed here, unless managed in a pharmacy program. The coverage of a medication listed here does not guarantee its availability through the mail order service program. To confirm if the medication is available through mail order, please call Informed Mail at 1-800-881-1966. This formulary is subject to change at any time.