To see our formulary, or list of covered drugs, choose your plan from the list below.
The Pharmacy and Therapeutics Committee, a group of Kaiser Permanente doctors and pharmacists, chooses which drugs to include in our formulary. To make sure you always have the most effective, safe, and affordable drug options, the committee regularly reviews information about new and existing drugs. The formulary is updated monthly based on new information or when new drugs become available.
Drugs that aren’t listed on the formulary, known as nonformulary drugs, aren’t covered by your plan.
If your doctor decides that a nonformulary drug is necessary for your care, your doctor can request an exception for that drug. With an exception, the drug will be covered under your prescription drug benefit — if your plan has one. Without an exception, you’ll be charged the full retail price for that drug.
The most effective way to get an exception to the formulary is to send a secure email to your doctor.
You can also contact Member Services by submitting an online form. Or you can call us, Monday through Friday, 7:30 a.m. to 5:30 p.m., at:
D.C. metro area: 301-468-6000
Other areas: 1-800-777-7902
If you paid for a nonformulary drug that you want covered by your plan, you can contact Member Services and ask for your prescription claim to be reviewed.
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