Prescription Drugs

AlohaCare covers certain prescription drugs for our QUEST Integration members.

 

The formulary is a list of the drugs that we cover.  Generally, we will cover the drugs listed on our formulary as long as the drug is medically necessary and the prescription is filled at a network pharmacy.  See below for information on restrictions and limitations.  We may add or remove drugs from our formulary during the year.  We will provide updates when the formulary changes.

For more information, click here. The formulary will tell you about:

  • The drugs included in our formulary
  • Quantity limits for drugs
  • Restrictions that apply to drugs such as prior authorization requirements
  • How to obtain prior authorization for a drug, if required
  • How your physician may request an exception to our formulary, including the documentation that we require to review this request
  • How you or your physician may appeal our decision not to approve the request for an exception
  • The Process of generic substitution of drugs
  • Step therapy requirements
  • Therapeutic interchange requirements
  • Any other requirements, restrictions, limitations, or incentives that apply to the use of certain drugs 

2018 QUEST Integration Formulary

July 13th update