IHN-CCO uses a “formulary” for prescription drugs. A formulary is a list of covered prescription drugs. All IHN-CCO providers have a copy of the formulary in their office. When you need a prescription, your doctor will choose a drug from the formulary. Drugs that are not on the formulary are called non-formulary. If you would like a copy of our formulary, call our Customer Service Department and we will send you one within five business days.
IHN-CCO covers many over the counter (OTC) drugs which will be listed on our formulary. If an OTC drug on formulary is listed with a limit on the number you can get, or prior approval is needed, you may need to get approval. If an OTC drug is not listed on the formulary, a prior approval will be needed before IHN-CCO will pay for the drug.
As an IHN-CCO member you can get birth control from any provider. You do not need a referral or prior approval.
If there are problems with the pharmacy filling your prescription, your provider can call our Customer Service Department.
If for some reason you need a drug that is not on the IHN-CCO formulary, your doctor can ask for an exception. Our Pharmacy Director will decide if it is medically needed for you to have a drug that is non- formulary. If you have a high medical need for the prescription, we will pay for the non-formulary drug.
Be sure to talk to your PCP, PCD or mental health provider who can provide the drug before you go out of town. They can help you get medication refills before you leave or tell you what to do if you run out of medication.
Search our formulary by medication name or type. Search results include:
- Any restrictions for the drug, such as prior authorization, quantity limits or step therapy requirements;
- The effective date of the formulary and the date it was last updated.
You may also download and print the IHN-CCO Formulary.