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Search drugs and pharmacies

A formulary is a list of drugs selected by GHP Family, which represents medications believed to be a necessary part of a quality treatment program.

Two nurses discuss a prescription behind a counter

Search covered drugs and pharmacies

See if a drug is covered

View the GHP Family formulary and the Statewide Preferred Drug List to search for covered drugs, including specialty medications, prior authorization requirements and in-network pharmacies.

GHP Family formulary (PDF)

Statewide Preferred Drug List

Questions: Call GHP Family Pharmacy Services
  • 855-552-6028 or 570-214-3554
  • Monday, Tuesday, Thursday, Friday: 8 a.m. – 7 p.m.
  • Wednesday: 8 a.m. – 8 p.m.
  • Saturday: 8 a.m. – 2 p.m.

GHP Family prescriptions

Geisinger Health Plan (GHP) follows the Statewide Preferred Drug List (PDL), which is developed by the Department of Human Services’ Pharmacy and Therapeutics Committee. Medications not on the PDL follow the GHP Family formulary.

View the statewide PDL.

Pharmacy copays

Some drugs require a copay, which is the amount you pay at the pharmacy when receiving your medications. You can’t be denied medication if you can’t afford the copay. Let your pharmacist know if you can't pay, although they can still try to collect it.

Copay amounts

Adults

  • Brand-name drugs: $3 per prescription or refill
  • Generic drugs: $1 per prescription or refill

Children

  • Brand-name drugs: $0 per prescription or refill
  • Generic drugs: $0 per prescription or refill
No copay required

The following members do not have to pay co-payments:

  • Members under age 21
  • Pregnant women (including 1 year after the child is born [the post-partum period])
  • Members who live in a long-term care facility, including Intermediate Care Facilities for the Intellectually Disabled and Other Related Conditions or other medical institution
  • Members who live in a personal care home or domiciliary care home
  • Members eligible for benefits under the Breast and Cervical Cancer Prevention and Treatment Program
  • Members eligible for benefits under Title IV-B Foster Care and Title IV-E Foster Care and Adoption Assistance
No copay medications
  • Antihypertensives (high blood pressure)
  • Antidiabetes (high blood sugar)
  • Anticonvulsants (seizure)
  • Cardiovascular preparations (heart disease)
  • Antipsychotics (except those that are controlled substance antianxiety drugs)
  • Antineoplastic (cancer drugs)
  • Antiglaucoma drugs
  • Anti-Parkinson's drugs
  • HIV/AIDS drugs
  • Preferred naloxone injection/nasal spray for drug overdose
Requirements for Pennsylvania pharmacies
  • Must be enrolled with the PA Department of Human Services (DHS)
  • Have a Pennsylvania Medicaid ID number. Check that the pharmacy has one before you give them your prescription.

GHP Family plan formulary updates

Health insurance plan formularies are regularly updated, like when new drugs are added or a drug is recalled.

These changes are listed in our GHP member newsletters, or you can check this page whenever you’d like.

Formulary changes

If we remove drugs from our formulary, or add prior authorization, quantity limits and/or step therapy restrictions on a drug or move a drug to a higher cost-sharing tier, we must notify affected members of the change (30 days for employer coverage and GHP Family; 60 days for other plans) before the change becomes effective.

Safety concerns

Drugs declared unsafe by the FDA or withdrawn by the manufacturer are immediately removed from the formulary, and affected members are notified.

Prior authorization

Some drugs require prior approval from GHP Family. Your prescriber must get this approval before the prescription can be filled. GHP Family will not cover the drug without approval.

If prior authorization is needed:

Option 1

If your medication isn’t on the Statewide Preferred Drug List or GHP Family formulary, you can share the lists with your doctor. They can tell if you if there’s an alternative that will work for you.

Call GHP Family Pharmacy Customer Service at 855-552-6028 or 570-214-3554 (PA Relay 711).

Hours:
Monday, Tuesday, Thursday, Friday: 8 a.m. – 7 p.m.
Wednesday: 8 a.m. – 8 p.m.
Saturday: 8 a.m. – 2 p.m.

Option 2

Your doctor can ask GHP Family to approve your current drug through a prior authorization. See our Geisinger policy.

Prior authorization policies and criteria
Formulary updates
Pharmaceutical and therapy committee notes
Specialty medications and pharmacy options

With GHP Family, you have access to the Navitus Specialty Pharmacy Network, allowing you to choose any specialty pharmacy in the network.

View network specialty pharmacies and specialty drugs list (PDF)

Out-of-network pharmacies can be used if:

  • The medication isn’t available at a network pharmacy due to "limited distribution" by the manufacturer
  • A network pharmacy can’t provide the medication in time to prevent harm

Searching for covered drugs and pharmacies

Call GHP Family Pharmacy Services at 855-552-6028 or 570-214-3554: Monday, Tuesday, Thursday, Friday: 8 a.m. – 7 p.m. | Wednesday: 8 a.m. – 8 p.m. | Saturday: 8 a.m. – 2 p.m.
Search the formulary

Members can sign in or create an account to search the GHP Family formulary and Statewide Preferred Drug List online

Search covered drugs and pharmacies

Search the GHP Family formulary, Statewide Preferred Drug List or find a covered pharmacy without signing in

View the PDF

See the GHP Family formulary (effective Sept. 1, 2024) and the Statewide Preferred Drug List