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Health Care Reform:

Health Insurance & Affordable Care Act

Back to ACA Health Insurance Terms List


Each health plan has a list of prescription medicines it covers. That list is called a formulary. The list includes generic and brand-name medicines. Your doctor may have to call your health plan to get approval to prescribe a certain medicine so you don't get charged the full price. Another way people say this is to say that a medicine needs prior authorization. The plan's goal is to encourage doctors to prescribe less expensive medicines.

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