Harvard Pilgrim Health Care Home
  Learn more.
  Sign up for HPHConnect.
Medical Management
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Office Support
Provider Manual
Medicare Advantage
Research & Teaching
Resources & Links
Print    Text Size

Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

November 2014

Reminder: Value Formulary Offered in 2015 

As we announced in last month’s issue of Network Matters, Harvard Pilgrim will be offering a new formulary option for employer groups beginning Jan. 1, 2015. The Value formulary is a closed formulary that will be offered in addition to our current open formulary (the Premium formulary). Harvard Pilgrim’s Value formulary balances cost-effectiveness with benefits, and was developed to include virtually all drug classes, with alternatives available in each class.

Formulary overview

The Value formulary will include most generic drugs and single-source brand-name drugs (i.e., those without generic equivalents), while multi-source brand name drugs are excluded. However, there are some exceptions, including the following covered multi-source brand name drugs: Dilantin, Tegretol XR, Synthroid, Levothroid, and Unithroid.

Information for providers and members

Harvard Pilgrim has developed a 2015 Value Formulary Non-Covered Drug List (Abridged) identifying commonly used medications excluded from the Value formulary, as well as their covered alternatives. A complete searchable formulary is also available in the pharmacy section of Harvard Pilgrim’s provider website.

To aid members who are transitioning to the Value formulary, Harvard Pilgrim will mail letters to members who have been prescribed medications in the last year that are not covered in the Value formulary, prior to the effective date of their coverage. This notification will include a list of the non-covered drugs and the covered alternatives, and will encourage the member to contact their physician to discuss which medication is appropriate for them.

For more details on the Value formulary, please refer to this FAQ. If you have any other questions or feedback about the Value formulary, contact Pharmacy Services at pharmacy_services@harvardpilgrim.org.

Email this article to a colleague   

Network Matters Archives

Download printer-friendly version


Join Us for the Mobile Farmers’ Market in Hartford

Let’s Go! Healthcare Launches Childhood Obesity Webinar Series

New WeighingIn Blog Creates an Online Community of Nutrition and Obesity Prevention Experts


Harvard Pilgrim Offers Reports to Help Improve Medication Adherence

Reminder: Value Formulary Offered in 2015

Prior Authorization on Select Opioid Analgesics

Reminder: Use of Non-Participating Ambulance Providers


A New Alliance: Health Plans, Inc. and UnitedHealthcare


Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,

Kristin Edmonston,
Production Coordinator