Insurance and Medications:
What you should know

Public and private insurers can limit your access to getting certain medicines. As such, there are several things you should know about getting medication:

Some companies have restrictive
formularies. Formularies are lists of
medicines which are covered under a health
plan. Medicines not on the formulary list
are not covered. Many newer, more effective
medicines used to treat mental illness are
expensive — and as such they may be
left off of formulary lists. This practice is
called a “restrictive formulary.”

Some insurers require that you use a
medicine on their formulary list first. This
practice is called a fail first policy. These
medicines usually cost less. If you don’t
get the results the mental health professional
expects from this medicine, then you may be
allowed to change to another medicine.