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Formulary

Commercial drug formulary
Medicare Part D drug formulary

Commercial drug formulary

Our drug-formulary process results in a constantly updated list of drugs that has been approved for our members by the Southern California Kaiser Permanente Pharmacy and Therapeutics Committee (P&T). This medical group committee thoroughly reviews medical literature and selects drugs for the formulary based on numerous factors, including safety, effectiveness, and affordability. Every SCPMG provider, through their local P&T, has an opportunity and is encouraged to participate in the formulary decision-making process, including requests for formulary additions, deletions, and status changes.

Drugs and supplies included on the drug formulary are covered under a member’s drug benefit. To be covered under the drug benefit, prescriptions must be dispensed from a Kaiser Permanente pharmacy, Kaiser Permanente mail-order pharmacy, or an affiliated network community pharmacy designated by the health plan (special out-of-network exceptions may apply). Please direct patients to Kaiser Permanente customer service with all questions regarding their network pharmacy benefit.

For more details on our commercial formulary and related pharmacy policies, services and contact information, search our consumer online drug formulary* (courtesy of Lexi-Comp)

Medicare Part D drug formulary

Our Medicare Part D drug formulary is a list of the prescription drugs that are approved for coverage by Kaiser Permanente Senior Advantage Plan.  For details relating to the drug formulary and pharmacy information for Senior Advantage (HMO) and (HMO-SNP), search our 2012 Medicare Part D formulary.* 

Information on the following topics is also available on the kp.org drug formulary and pharmacy* pages:

  • Using the formulary
  • Changes to the formulary
  • Getting an exception to the formulary
  • Transition process for medications
  • Kaiser Permanente pharmacies
  • Out-of-network pharmacy coverage
  • Rx refills and mail order services
  • Other important Medicare Part D information
  • Contact information
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