Pharmacy & Drugs

A prescription drug benefit with broad prescription drug coverage is included in our group health plans.

Formularies: Lists of covered prescription drugs

Pharmacy benefit information for:

Upcoming formulary changes

• Monthly Group Value and Group Choice Formulary Changes
• Monthly Essential Health Benefits Formulary Changes

Preventive care medications

Under the Affordable Care Act, also known as the healthcare reform law, Baylor Scott & White Health Plan covers some preventive care medications at 100% without charging a copay, coinsurance or deductible. The following list of drugs and products require a prescription (including over-the-counter medications) and must be filled at a network pharmacy to be covered at no cost share.

Specialty Pharmacy Drug Program

The Specialty Pharmacy Drug Program offers the choice of two specialty care pharmacies to help manage and access specialty drugs.

• Specialty Pharmacy Program

BSWHP Medications Restricted to Pharmacy or Medical Benefit

BSWHP has certain medications that are restricted to the Pharmacy or Medical Benefit. For more information on these medications, visit the link below. :

• BSWHP Medications Restricted to Pharmacy or Medical Benefit

Pharmacy locator

• Find network pharmacies by using the Provider Directory and Pharmacy Locator.

Forms and drug requests

• Baylor Scott & White Mail Order Form
• OptumRx Pharmacy Mail Order Form
• Pharmacy Claim Form
• Drug Requests - Prior Authorizations, Exceptions and Appeals