Quartz Standard Choice Provider Formulary

Standard Choice Formulary

For members whose pharmacy benefits are covered by a fixed copay on a three- or four-tier plan.

Individual & Family plans
(Not available in Iowa)

Select this formulary if you have an Individual/Family plan through the Health Insurance Marketplace. For questions or to verify your plans coverage, please contact Member Services at (800) 496-7509.

Online searchable formulary for Individual & Family plans | Individual & Family formulary PDF

Small Group plans – Less than 51 employees

Select this formulary if you have an employer-sponsored health plan and your employer has fewer than 50 employees. For questions or to verify your plans coverage, please contact Member Services at (800) 496-7509.

Online searchable formulary for Small Group plans | Small Group formulary PDF

Large Group plans – 51 or more employees

Select this formulary if you have an employer-sponsored health plan and your employer has more than 50 employees. For questions or to verify your plans coverage, please contact Member Services at (800) 496-7509.

Online searchable formulary for Large Group plans | Large Group formulary PDF

Quartz Align (ASO/Self-funded)

Select this formulary if you have a self-funded employer-sponsored health plan. Not all Quartz Align plans include pharmacy benefits. If you are unsure, have questions, or wish to verify coverage please contact Member Services at (844) 880-0762.

Online searchable formulary for Quartz Align (ASO) plans | Quartz Align (ASO) formulary PDF

What is a formulary?

The formulary is the list of medications covered by Quartz through the prescription drug benefit. This formulary includes drugs covered for ALL fully insured policies.

Certain drugs on the formulary may not be covered by your specific plan. Some plans cover drugs not listed on the formulary. The differences are based on what type of plan you have and/or:

• If you have employer-based or individual coverage through Quartz
• What state you live in or your employer is based in
• If your benefit plan meets the requirements of the Affordable Care Act

This means that even though a drug is listed on this formulary, it may not be covered by your specific benefit plan. Please see your Quartz Prescription Drug Benefit Rider or contact Quartz Customer Success at (608) 881-8271 or (800) 897-1923 to verify your coverage.

• Standard Choice Formulary Updates

State and Local Government Members

Please visit Navitus for information about your prescription drug benefits.

BadgerCare Plus and/or Medicaid SSI Members

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