Formulary Medications



What are Formulary Medications?

Formulary drugs are reviewed and recommended by Highmark Wholecare's P&T Committee. They are are chosen based on safety, efficacy, quality and cost. Doctors and pharmacists should use formulary drugs when appropriate. Highmark Wholecare ONLY covers Food and Drug Administration (FDA) approved drugs. 



This information is issued on behalf of Highmark Wholecare, coverage by Gateway Health Plan, which is an independent licensee of the Blue Cross Blue Shield Association. Highmark Wholecare serves a Medicaid plan to Blue Shield members in 13 counties in central Pennsylvania, as well as, to Blue Cross Blue Shield members in 14 counties in western Pennsylvania. Highmark Wholecare serves Medicare Dual Special Needs plans (D-SNP) to Blue Shield members in 14 counties in northeastern Pennsylvania, 12 counties in central Pennsylvania, 5 counties in southeastern Pennsylvania, and to Blue Cross Blue Shield members in 27 counties in western Pennsylvania.

Health benefits or health benefit administration may be provided by or through Highmark Wholecare, coverage by Gateway Health Plan, an independent licensee of the Blue Cross Blue Shield Association (“Highmark Wholecare”). Highmark Wholecare offers HMO plans with a Medicare Contract. Enrollment in these plans depends on contract renewal.

Medicare Ombudsman Website Best Available Evidence
Medicare Ombudsman Website Best Available Evidence


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