Your doctor may prescribe medication as part of your healthcare. It is important that you follow your doctor’s instructions and take the medication as your doctor has prescribed it.
You must have your prescription filled by a Health Choice Utah participating pharmacy. Click here to search for a participating pharmacy in your area in the Provider Directory.
Health Choice Utah provides a closed drug Formulary (medicine) benefit for its members. We may have to approve a drug if it is not already listed in the formulary.
About the Health Choice Utah Formulary
The Health Choice Utah Formulary is your guide to prescription drugs covered by Health Choice Utah. The Formulary is organized by sections. Each section includes therapeutic groups identified by either a drug class or disease state.
What will I find in the formulary?
- Generic products
- Brand name products
- Covered dosage and strengths (exceptions may apply)
- Over-the-counter (OTC) products
The Utah Department of Health (UDOH) covers the following drugs
- Hemophilia drugs
- Organ transplant immunosuppressants
- Mental health related drugs
For information or assistance with prescriptions covered by Utah Department of Health (UDOH), you may also contact:
Health Program Representative
Medicaid Information Line
Here is how you can view or search the Formulary:
Click here to view or print a PDF of our Comprehensive Formulary.
Health Choice may add or remove drugs from our formulary during the year.
Click here to view recent Formulary Adds and Deletions.
Brand Name vs. Generic Drugs
Health Choice Utah covers both brand name and generic drugs. Generic drugs have the same active ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs. Generic drugs are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.
Prescription Drug Restrictions and Limits
Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include:
Prior Authorization: Health Choice Utah may require prior authorization for certain drugs. If you do not get approval, Health Choice Utah may not cover the cost of the drug. Click here to view Prior Authorization Criteria
Quantity Limits: For certain drugs, Health Choice Utah may limit the amount of the drug that our plan will cover. For example, Health Choice Utah provides 30 units per 30 days of Zolpidem.
Step Therapy: In some cases, Health Choice Utah requires a member to try certain drugs before trying others. Please refer to the Health Choice Utah Formulary to find out if a drug has additional requirements or limits. Click here to view Step Therapy Policy.
You can ask Health Choice Utah to make an exception to these restrictions or limits. Call Member Services for more information about prescription drug restrictions or limits.
1-877-358-8797 (TTY 711)
Monday – Friday, 6AM – 6PM
For information and assistance with prescription drugs, call toll-free: 877-358-8797
For information about prescription drugs covered by UDOH, visit the UDOH website:
Utah Medicaid Pharmacy Website