Member Support

Covered Drugs

Covered Drugs
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Horizon NJ Health covers many medications that are offered to you at a low cost. These approved drugs make up our formulary.

If your doctor wants to prescribe a drug that is not included in our formulary, he or she will need to call us to get prior authorization, or approval in advance.

It is important that the medications you take are safe and effective. That is why Horizon NJ Health has a committee made up of practicing doctors and pharmacists that reviews and approves our formulary.

The Approved Drug List (formulary) is updated annually and as changes are made or new medications approved.  The Approved Drug List is updated as of the date that formulary changes are put in place.  Changes to the Approved Drug List are included in the member newsletter mailed to all members on a quarterly basis.

  • Covered pharmaceuticals are in the “Approved Drug List” noted below.
  • Copayment: The amount a person must pay for a health care service at the time the service is given.

The copayments for prescription drugs (retail pharmacy) are listed in the chart below.

Benefit Plan Copayment
NJ FAMILYCARE A $0
NJ FAMILYCARE ABP $0
NJ FAMILYCARE B $0
NJ FAMILYCARE C $1 for generic drugs

$5 for brand-name drugs
NJ FAMILYCARE D $5 for generic and brand-name drugs

$10 if greater than a 30-day supply
  • Pharmaceuticals that require prior authorization are noted in the “Approved Drug List” noted below.
  • Please note that Horizon NJ Health maximum days supply limit is 30 days.

If you have any questions, please call the Horizon NJ Health Pharmacy Department toll free at 1-800-682-9094.