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The formulary is a tool to promote appropriate and cost-effective prescription drugs for Tufts Health Direct members. Providers should refer to the formulary to confirm the drugs being prescribed are covered by Tufts Health Plan. The Pharmacy and Therapeutics Committee reviews and revises the formulary on a quarterly basis to reflect the committee’s prevailing clinical opinion. Each quarter, formulary updates are included in Provider Update. To register to receive Provider Update by email, complete the online registration form.
Visit the Pharmacy Updates page to find monthly pharmacy updates for Tufts Health Public Plans members.
Some drugs require prior authorization. To request a drug authorization for a Tufts Health Public Plans patient, fax the appropriate medication request form.
For Tufts Health Direct members, requests are reviewed and initial determinations regarding prior authorizations are made within two business days of receiving complete medical information. Once a decision is made, Tufts Health Plan will notify providers by telephone or fax within one business day.
Visit the Pharmacy Copayments page for more information.