Formulary (covered drugs)

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Maryland, Virginia, and Washington, D.C.

Preventive drugs

Kaiser Permanente offers preventive drugs at a lower cost share. Please consult your Evidence of Coverage (EOC) to determine if you are eligible for a lower cost share on preventive drugs.

Preventive drug list (PDF)

Medicare Part D formulary

Learn more about our drug formulary for Medicare Plus (Cost) and Medicare Advantage (HMO) members:

Medicare Part D formulary

Changes to the formulary

Our Pharmacy and Therapeutics Committee thoroughly reviews medical literature and selects drugs for our formulary based on how safe and effective they are, among other factors. The committee meets regularly to consider changes to the formulary based on new information or new drugs that become available.

Getting an exception to the formulary

Drugs not listed on the formulary are called non-formulary or non-preferred drugs. A non-formulary medication is generally available at a higher cost. Please consult your Evidence of Coverage for additional information regarding coverage of non-formulary medications specific to your plan. 

The most effective way to get an exception to the formulary is to send a secure email to your doctor. You and your doctor are best able to determine your medication needs.

You may also contact Member Services by submitting an online form. Or call Member Services Monday through Friday from 7:30 a.m. to 5:30 p.m. at:

  • 301-468-6000
  • 1-800-777-7902 (toll free)
  • 301-879-6380 (TTY for hearing/speech impaired)

If you paid for a non-formulary or non-preferred prescription and you wish to appeal the decision that the prescription is covered, you may contact Member Services and ask that your prescription claim be reviewed.

Request to add or delete medications

Our Pharmacy and Therapeutics Committee will consider requests from Kaiser Permanente members, physicians, or pharmacists to add or delete medications on our formulary. You can download a form to submit this request (PDF).

Have questions?

For more information about our drug formulary, or to receive a copy of the drug formulary, please call Member Services from 7:30 a.m. to 5:30 p.m. Monday through Friday at:

  • 301-468-6000
  • 1-800-777-7902 (toll free)
  • 301-879-6380 (TTY for the hearing/speech impaired)

You can also send a secure message to Member Services.

Reviewed by: Megan Famodu, PharmD, May 2014

NCQA content reviewed by: Susan O’Hardy, NCQA Lead, February 6, 2014

This page was last updated: October 8, 2018, at 12 a.m. PT

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