Go to legend

Drug Name Search

Nonformulary and excluded drugs are not included in the formulary listing.

By Alphabet

Select a letter to view drugs starting with that letter

By Therapeutic Class

Please select a therapy class to continue

Legend

  • $0
    Zero Dollar Cost Share
  • T1
    Preferred Generics
  • T2
    Preferred Brands
  • T3
    Non-preferred Generics and Brands
  • T4P
    Preferred Specialty Cost Share
  • T4N
    Non-preferred Specialty Cost Share
  • MB
    Medical Benefit Drugs
  • NF
    Non-Formulary
† Denotes brand name drug, otherwise generic drug
BRAND NAMES
generic names

STANDARD CHOICE FORMULARY

Quartz Health Solutions, Inc.

This formulary serves members whose pharmacy plans have 3 or 4 copay tiers (sometimes referred to as an "open" benefit).

What is the Formulary?

The formulary is the list of medications covered by Quartz on the prescription drug benefit. It is created by the Quartz Pharmacy and Therapeutics Committee. The formulary is updated regularly. Certain drugs on the formulary may not be covered by your specific plan. Differences may be based on:

  • If you have employer-based or individual coverage.
  • The state you live in or your employer is based in.
  • If your plan meets the requirements of the Affordable Care Act.
  • Please see your Quartz Prescription Drug Benefit Rider or contact Quartz Customer Service at (800) 362-3310 to verify your coverage.

    Printable Files

    The following files require Adobe Acrobat. Download Adobe Acrobat

    How to Search For Drugs

  • Use the alphabetical list to search by the first letter of your medication.
  • Search by typing part of the generic (chemical) and brand (trade) names.
  • Search by selecting the therapeutic class of the medication you are looking for.
  • Requesting a Prior Authorization

    Requests for coverage of restricted drugs (prior authorization) or to show medical necessity of nonformulary drugs may be submitted to Quartz for review by:

  • Reviewing the Medication Prior Authorization Criteria for Coverage on the Quartz website.
  • Submitting the Medication Prior Authorization Request Form.
  • Calling (888) 450-4884 to initiate a request.
  • Additional information can be found in the Frequently Asked Questions documents on QuartzBenefits.com