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Provider Manual Member Eligibility and Benefits Determination Product Descriptions Drug Benefits and Formulary 8/31/2012Welcome To Kaiser PermanenteThis section of the Provider Manual was created
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Drug benefits are the specific medications covered by a health insurance plan, while a formulary is a list of these medications.
Health insurance companies are required to file drug benefits and formulary with regulatory bodies.
Drug benefits and formulary can be filled out by providing information about the covered medications, their costs, and any restrictions.
The purpose of drug benefits and formulary is to inform members of the medications covered by their insurance plan and to guide healthcare providers in prescribing medications.
Information such as the name of the medication, its cost, any restrictions or prior authorizations needed, and coverage details must be reported on drug benefits and formulary.
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