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2025 Quartz Formulary
Individual & Family Wisconsin
Quartz Formulary
The formulary is the list of medications covered by Quartz through the prescription drug benefit. The formularies are for Individual & Family plans through the Health Insurance Marketplace (on-exchange) as well as for Individual & Family plans purchased directly from Quartz (off-exchange).
If you are already a Quartz member the best way to ensure you are looking at the correct formulary is to go to Quartz MyChart.
For questions or to verify your plans coverage, please contact Member Services at (800) 496-7509.
Drug tiers determine the coverage and cost of the prescription drug benefit. Each tier has a distinct cost-share. The higher the tier, the more expensive the drug, therefore higher out-of-pocket cost for the member.
Empower yourself by knowing which tier your prescriptions are in. Look up your drug name on the printable formulary and find the corresponding tier.
Standard Plans will continue to offer 4-tier pharmacy benefit plans. The cost shares for the Standard Plans are determined by the Centers for Medicare and Medicaid Services (CMS) and will be uniform across all payers. Quartz continues to offer High Deductible Health Plans (HDHP).
These plans:
- May include coinsurance after the initial deductible is met
- Include a “Safe Harbor” list of selected drugs and supplies at $0 cost to members before the deductible is met
All pharmacy plans include coverage of preventive drugs as recommended by the United States Preventative Services Task Force (USPSTF) at $0 cost to members.
Looking for 2024? Click Here
Drug tiers determine the coverage and cost of the prescription drug benefit. Each tier has a distinct cost-share. The higher the tier, the more expensive the drug, therefore higher out-of-pocket cost for the member.
Empower yourself by knowing which tier your prescriptions are in. Look up your drug name on the printable formulary and find the corresponding tier.
Quartz continues to offer High Deductible Health Plans (HDHP). These plans will use the 6-tier formulary structure. Under these plans, members will pay the cost of all prescription drug services until the plan limit is met.
These plans:
- May include coinsurance after the initial deductible is met
- Include a “Safe Harbor” list of selected drugs and supplies at $0 cost to members before the deductible is met
All pharmacy plans include coverage of preventive drugs as recommended by the United States Preventative Services Task Force (USPSTF) at $0 cost to members.
Need more information? See all Plan benefits
Looking for 2024? Click Here
Contact us
Quartz is here to help. That’s why we make it easy to reach us.
Call Quartz Customer Success (844) 644-3455 or message us on Quartz MyChart.