A formulary is a list of prescription drugs may be covered by a PBM or health plan. Your formulary provides detailed information on what drugs may be covered, but actual coverage is based on your plan design and whether limitations and requirements have been met. Limitations and requirements are noted within the formulary. Refer to your plan documents for applicable coverage exclusions.
Student Formulary Features
40+ free generic options
In addition to the $0 medications available under ACA preventive requirements, the Wellfleet Rx Student Formulary offers 40+ antibiotic, dermatology, and behavioral health medications at no copay*. Refer to the “Zero Cost Generics” section of the Student Formulary for the full list of medications covered under this program. We encourage you to share this list with your prescriber if you are receiving a medication in one of the categories featured to determine if a zero cost option may be appropriate for your treatment.
*Zero Cost Generics program may vary by school or may not be available to certain schools. See applicable Student Formulary for more details. If there is no “Zero Cost Generics” section included in the Student Formulary applicable to your plan, this program is unavailable.
Helping you avoid high-cost generic drugs
Preferred generics are available under the tier 1 of the Wellfleet Rx Student Formulary. Compared to their higher cost generic counterparts, the preferred generics have been reviewed for similar efficacy and clinical indications and similar side effect profiles. To help allow students and their providers to make informed decisions and drive them toward preferred generics, some high cost generics may be placed in a higher formulary tier and be associated with higher copays. Students are encouraged to discuss preferred generic alternatives with their providers when prescribed a non-preferred generic. Pharmacies will receive point-of-sale messaging and students will receive letters when non-preferred generics are prescribed to provide education on preferred, lower cost alternatives.
Preventing opioid abuse
The STOP program from Wellfleet Rx promotes safety and appropriateness before opioids are dispensed through improved drug utilization controls. The Wellfleet Rx Student Formulary includes utilization management requirements and limitations on opioids to prevent excessive opioid dispensing and unnecessary long-term opioid use. Formulary controls include days supply limitations, prior authorizations on refills, and cumulative dose threshold reviews.