Below is a list of formularies provided by Bluegrass Family Health. Please refer to your pharmacy benefit to determine which formulary applies to your prescription coverage. You may also call the Pharmacy Services Department at 877-205-6308 or 859-335-3755 with further questions.

K4 - KY 4th Tier Preferred Drug List (effective 07/1/2008)

KM - KY Master Preferred Drug List (effective 07/1/2008)

TM - TN Master Preferred Drug List (effective 07/1/2008)

T4 - TN 4th Tier Preferred Drug List (effective 07/1/2008)

FF - Federal Preferred Drug List For Federal Employees (effective 07/1/2008)

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What is a formulary or preferred drug list?

A formulary or Preferred Drug List (PDL) is a listing of medications covered under your Bluegrass Family Health, Inc. (BFH) pharmacy benefit. Not all drugs will be listed on the formulary. Generic drugs in most cases are covered at a 1st Tier copay. Exceptions are generic drugs manufactured by one generic company; these are commonly known as "branded generics." If your medication is considered a "brand name drug" and is not listed on the formulary (PDL), in most cases it will be covered at a 3rd Tier copay. Other drugs may not be covered as they are considered a benefit exclusion. Examples of excluded drugs are medication for weight loss, smoking cessation, lifestyle drugs, hair loss, and drugs used for cosmetic conditions.

If you are not sure if your medication is an excluded drug please ask your Doctor or Pharmacist. You may also call Pharmacy Services at Bluegrass Family Health at
(877) 205-6308 or (859) 335-3755 from 8:00 am to 6:00 pm ET or contact us via email at pharmacy@bgfh.com.

Drugs indicated for weight loss, smoking cessation, lifestyle drugs, hair loss, and drugs used for cosmetic conditions are benefit exclusions. Other exclusions include drugs being used for investigational use, experimental use, and non-FDA indications. Drugs being used for a non-FDA indication are commonly referred to as "off label" use. Generally, "off label" use means no well controlled studies have been conducted to treat medical conditions other than approved FDA indication.

Most drugs have maximum dosage limits stipulated by the FDA and pharmaceutical companies. Excessive use of medication on the quantity limit list (QL) may lead to serious health conditions. For example, over use of acetaminophen could cause liver failure. BFH strives to stay within all FDA guidelines to help ensure safe utilization medications to our members.

In an attempt to encourage our members use the most cost effective and best studied medication regimens for BFH members, our clinical staff has created a list of drugs that should be tried first before using a newer, less studied, costly agent.