List of Drugs (Formulary)
The comprehensive List of Drugs (Formulary) is the list of drugs that are covered by Michigan Complete Health (MMP). The List of Drugs are covered as long as the drug is medically necessary. To get the drug covered, fill it at a network pharmacy. You can also use the mail order program for maintenance drugs. Some coverage rules must be followed. Some drugs have limits for coverage.
The drugs on the List of Drugs are chosen by drug plan and health experts. The drugs are reviewed by a group of doctors and pharmacists who do not work for the plan. This group is call the Pharmacy and Therapeutics Committee.
The List of Drugs does not have all drugs on it. Some drugs are not a covered benefit, or are excluded. Other drugs are not on the list of drugs because of clinical or cost reasons.
Certain drugs that require prior authorization may be covered under Medicare Part B or D depending upon the circumstances. Information may need to be submitted describing the use and setting of the drug to make the determination.
Michigan Complete Health (MMP) may add or remove drugs from our List of Drugs during the year. If we remove a drug from our formulary, add prior authorization or quantity limits on a drug and/or move a drug to a higher cost-sharing tier, we will notify members and providers of the change at least 60 days before the date that the change becomes effective. However, if the Food and Drug Administration deems a drug on our List of Drugs to be unsafe or the drug’s manufacturer removes the drug from the market, we will immediately remove the drug from our formulary. For the most current list of drugs contact Member Services.
Please call Michigan Complete Health (MMP) Member Services at 1-844-239-7387. Hours are from 8 a.m. to 8 p.m., seven days a week. TTY users call 711. On weekends and on state or federal holidays, you may be asked to leave a message. Your call will be returned within the next business day.