For MVP members who have a prescription drug rider as part of their benefit plan,
MVP has in place a "drug formulary" which is a program that determines our approved
list of covered medications – those proven safe and effective, in the best interests
of our members. Here are answers to some of the questions you may have about this program.
What drugs does MVP cover?
How does MVP decide which drugs to cover?
What about new drugs–does MVP cover them?
What if my doctor says I need a drug that MVP doesn't cover?
Are there any drugs that require prior approval before MVP will pay for them?
What drugs does MVP cover?
MVP's approved list of medications includes thousands of drugs, both generic and name-brand.
In the cases where we do not cover a certain drug, we usually cover an alternative drug. To
find a specific drug on this list, use our
Rx Search.
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How does MVP decide which drugs to cover?
Decisions on which drugs we cover are made exclusively by the MVP Pharmacy and Therapeutics
Committee, which is comprised of primary care and specialty physicians, pharmacists and other
health care professionals. The committee is dedicated to selecting drugs
which are proven safe and effective for our members.
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What about new drugs – does MVP cover them?
MVP wants to ensure that members have access to the latest advances in medicine. Every month,
new prescription drugs are reviewed for potential addition to our approved list. However, no newly-introduced drugs
will be covered until the MVP Pharmacy and Therapeutics Committee has reviewed them. If the committee
determines that a new drug represents a significant advantage over existing drugs, MVP will cover the new drug.
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What if my doctor says I need a drug that MVP doesn't cover?
MVP places great confidence in the clinical decisions of participating physicians and recognizes that
there are instances where a drug that is not covered may be required for appropriate care. In such cases,
MVP may grant a Medical Exception and pay for the drug at no additional copay.
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Are there any drugs that require prior approval before MVP will pay for them?
Yes, a few drugs require MVP prior approval to be covered. Specific written policies for these drugs are available
by contacting our Member Services Department via e-mail
or toll-free at 1-888-MVP-MBRS (1-888-687-6277).
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For MVP members who have a prescription drug rider as part of their benefit plan,
MVP has in place a "drug formulary" which is a program that determines our approved
list of covered medications – those proven safe and effective, in the best interests
of our members. Here are answers to some of the questions you may have about this program.