Drug Lists / Formularies

Use these tools to determine generic and brand name medications covered by Scripius for your patients:

  • RxSelect is the covered drug list for most clients and members. It generally consists of four tiers of coverage, with drugs on lower tiers typically having a lower cost.

 

Drugs with Special Requirements

Use our drug search tool to identify medications needing step therapy or preauthorization. The tool also provides links for submitting these requests.

 

Drug Preauthorization and Exceptions

  • Submit Electronic Preauthorization (ePA) requests for prescription preauthorization through your integrated Electronic Medical Record (EMR) for fastest service.
  • If you are unable to use your Electronic Medical Record (EMR) to submit preauthorization requests you can also submit requests through our PromptPA tool.
  • The Drug Exception Form can also be used for exception requests.

Colorado prescribers may also use the statutory Uniform Pharmacy Prior Authorization Request form**, the Colorado Standard Exception Form for Contraceptive Products, or the Colorado Serious Mental Illness Step Therapy Exception form. Colorado prescribers serving Select Health members enrolled on the Colorado Option Plan can access a list of covered diabetic supplies here: Covered Diabetic Supplies for Colorado Option Plan. Nevada prescribers may also use the Nevada Standard Exception Form for Contraceptive Products. 

 

Specialty Drugs

Access additional resources for prescribing specialty drugs:

 

* Scripius is the PBM for Select Health. Select Health, as a provider of Medicare Part D, is required to give sufficient notice to all affected parties (including pharmacies, State Pharmaceutical Assistance Programs, physicians, and pharmacists) whenever a negative formulary change is made. The negative formulary change communication notifies an affected party that information is frequently posted to our website regarding upcoming formulary changes. Select Health updates this formulary monthly (as directed by CMS). In this process, we may make negative changes to accommodate new generics coming to the market as well as other market changes. Changes will be posted at least 30 days before the formulary changes go into effect. Patients affected by the formulary changes will be sent a written change notice at least 30 days before the change goes into effect. Questions? Please contact Select Health at 855-442-9988. 

**Colorado Prescribers: If additional information is required to process an urgent or non-urgent preauthorization request, the prescribing provider shall submit the information requested by the carrier within two (2) business days of receiving a request for additional information from Select Health or Scripius.  A preauthorization request will be deemed approved when criteria are met or turnaround time lapses. A request will be deemed denied when clinical criteria are not met or when additional request information cannot be obtained within the regulatory requirements.