We offer multiple drug formularies, depending on your plan. To determine which formulary you should reference, please see your Summary of Benefits (SOB) document or contact Pharmacy Services at (800) 545-5015 or (608) 260-7803.

You can also view your formulary by logging in to MyChart and using the Rx Manager tool.

Which Formulary Should I Choose?

The information below will help you to identify which formulary is applicable to you. However, the best way to access the correct formulary is through MyChart or reviewing your Summary of Benefits.

The formulary below serves members with HSA plans and features and one or two tier pharmacy benefit.
All other drugs require prior authorization before coverage applies to deductible and coinsurance.

Two Tier Legacy

The formularies below serve members whose pharmacy benefits are covered by a fixed copay on a three or four tier pharmacy benefit.

Three Tier Legacy

Four Tier Legacy

The formulary below serves members whose pharmacy benefits are covered by a fixed copay on a five tier pharmacy benefit.

Premier

The formulary below serves members whose pharmacy benefits include a Preventive Drug List with all other formulary drugs processing as HSA.

Companion Value Formulary


Questions?

If you have questions about your Pharmacy Benefits, please call Customer Service Monday – Friday from 8 a.m. to 5 p.m.

  • Toll Free: (800) 545-5015
  • Local: (608) 282-8900
  • TDD / TTY: 711 Wisconsin Relay

BadgerCare Plus Members

Please call the Department of Health Services at (800) 362-3002 for information about your prescription drug benefits.

This health plan is underwritten by Physicians Plus Insurance, Inc.