back to decision support

Formulary Data

With prescription drugs costs accounting for 20% of U.S. Healthcare spending, understanding how your health plan covers your prescription drugs and finding drugs at the lowest possible tier level is critical.

Speak to an Expert

Formularies

Comprehensive formulary coverage across the carriers and states in the fully insured markets

will be replaced with SVG code

Fully Insured Group

will be replaced with SVG code

Under 65 Individual

will be replaced with SVG code

Medicare Advantage PD

Use Cases

Our comprehensive formulary data powers mission critical functionality.

Shop-by-Drug

Finding a health plan that supports your prescription drugs at the lowest possible cost can provide for significant healthcare savings. Vericred’s formulary data powers “shop-by-drug” on exchanges, WBEs, and broker quoting solutions.

will be replaced with svg code

Benefits Administration

Why send employees to the carrier website when you can deliver your own drug search capability based on Vericred’s formulary data?

will be replaced with svg code

Drug Search

Digital health app developers leverage Vericred’s formulary data to enable drug search, helping individuals understand plan coverage and costs.

will be replaced with svg code

The Details

will be replaced with SVG code

Key Elements

  • Drug tiers
  • Restrictions (step therapy, quantity limits, prior auth)
  • Drugs mapped at the formulary, HIOS Plan, and Contract ID levels
  • Weekly refresh cycle
will be replaced with SVG code

File Formats

  • csv
  • json

View Documentation

style svg

Interested in Learning More?