Pharmacy Overview

Commercial

This section includes information on formularies, guidelines and forms for Tufts Health Plan Commercial products.

Refer to the Resource Center to find additional pharmacy information, and a complete list of Pharmacy Medical Necessity Guidelines, for Tufts Health Plan Commercial products.

• Formularies: A complete list of drugs covered on Commercial large group and small group formularies as well as a description of the formulary tier structures.
• Pharmacy Updates: Lists of monthly modifications to the drugs covered on our formularies.
• Pharmacy Utilization Management: A description of Pharmacy Utilization Management programs and related resources.
• Pharmacy Prior Authorization Request Forms: Information on which form to use to request prior authorization for both the prescription drug benefit and the medical benefit.
• Specialty Pharmacy and Specialty Infusion Programs: Includes a description of the specialty pharmacy and specialty infusion programs, a list of covered specialty medications provided by CVS Specialty, and a list of office-administered medical drugs that are available through CVS Specialty.