Employer Plans Formulary / Rx Drug Lists

Welborn Health Plans (WHP) provides Prescription benefit coverage locally and nationally though MedImpact, Inc. Please click on the link to search for a full listing of MedImpact national pharmacy locations.

Selected Phamaceutical List (A.K.A. "Formulary List ")

Selected Pharmacy Drug List

The list of Preferred Drugs (level 2) that is developed and subject to change at the direction of the Welborn Health Plans Pharmacy & Therapeutics (P&T) Committee. The P&T Committee periodically reviews drugs, or entire classes of drugs, to determine a drug’s status as preferred or non-preferred on a quarterly basis. This determination is made based on the medication’s safety, effectiveness, and cost. Non-Preferred Drugs (level 3) are Covered (subject to Limitations & Exclusions stated in your Certificate of Coverage), but usually require a higher co-pay.

"Retail Pharmacy" Maintenance Drug Program

"Value Added" Program, members can now purchase 90-day supplies of Maintenance Drugs at a participating local retail pharmacy. You can also click on the MedImpact link to see a full listing of national pharmacy locations. Please Contact Us for more information on this program and to find a participating pharmacy near you.

Pharmacy Locations in Indiana
Pharmacy Locations in Illinois
Pharmacy Locations in Kentucky
Pharmacy Locations in Ohio

"Mail-Order Pharmacy" Program

Convenient Home Delivery Mail Service makes it easier to receive your maintenance medications. You get the same, high-quality prescriptions, dispensed by registered pharmacists, without leaving your home.

Mail Service Prescription Drug Form

Quantity Limitation Medication List

As a part of the quality management program for WHP, quantity limitations have been placed on selected medications. The purpose of this program is to promote appropriate medication use. Amounts that exceed the recommended limitations will not be covered by the WHP Pharmacy Benefit.

Prior Authirozation Medication List

Prior Authorization Medication List

WHP requires that physicians obtain approval before prescribing certain medications. This process helps to ensure that medications are prescribed using well-established medical guidelines. If a member does not fit the criteria that are established for each medication, WHP will work with the physician to find a suitable alternative for our members.