About This Data

The information provided in the CA Internet Formulary reference is provided by the InfoScan Division of Managed Markets Insight and Technology, LLC. InfoScan provides similar information in its CA Managed Care Formulary guide to practicing physicians in California.

The data contained in the CalChoice Internet Formulary Reference is provided by the health care organizations that are included behind the Listing of Plans menu item. The Site provides the formulary status for more than 600 pharmaceutical products. The fact that a drug is not included in this site does not necessarily mean that it is not on a particular managed care formulary. InfoScan assembles the data into a standardized data set contained as a subset of the InfoScan Formulary database, a national database of formularies for over 1100 managed care organizations. Once standardized, the information is accumulated and published in books or web sites such as this.

InfoScan specializes in collecting and interpreting formulary information for the health care industry. InfoScan employs professional pharmacists to manage the formulary data interpretation and data entry processes. The data provided here is regularly updated as changes are received from the CA health care organizations. The information is valid through the dates shown under the valid date column.

Public Domain Data Copyright

Formulary information is classified as public domain information. It cannot be owned by any party including the health plans that provide it. It can be formatted in certain published formats and protected under US copyright law. The information on this web site consists of pre-exisitng facts.Some of the information contained in this database is also available on individual plan web sites. Some of the information contained in the InfoScan database but not necessarily in this data set is obtained from such public sites.

All of the information provided here is selected and formatted by InfoScan using InfoScan's formatting and in such formats is protected under InfoScan / MMIT copyrights.

Plan Information

This is a list of organizations (HMO plan or medical group) that publishes the formulary appearing under their name. The member services phone number is presented for the user's convenience. Please refer to the Effective Date and Valid Date which explain these two columns.

Information Dates

Formularies are dynamic. They are continuously changing as new drugs are added and old drugs are deleted, as plans add or change benefits and when some plans are bought or merged into others. Also drugs may remain in a formulary but change status from time to time.

InfoScan receives notice from the plans at about the same time as physicians do. However in an effort to maintain the best information, InfoScan checks with the listed CA plans on a monthly basis to be sure we have the latest information. There is no fixed schedule to these changes! There may be several changes at one time or no changes for several months. The schedules provided here match the information given to your physicians by these Health Care organizations. InfoScan cannot guarantee the 100% accuracy or completeness of this formulary information.

Accuracy

It is our intention to provide data that is as accurate as possible. As there is no industry standard for Drug statuses, the information contained here is subject to interpretation. For instance what one plan may call a preferred drug another may call Approved. InfoScan strives to standardize the information to the following interpretation.

 
Status Symbol(s) Interpretation
Preferred preferred.gif (948 bytes) Preferred over all other drugs in the same therapeutic category.
Approved approved.gif (726 bytes) Approved for reimbursement without any restrictions.
Prior Authorization priorauth.gif (563 bytes) Reimbursement will be allowed only when the claim has been submitted to plan officials by a prescriber for review prior to the issuance of a prescription.
Non-Formulary nonform.gif (1249 bytes) The Plan lists this drug as not on the formulary. Please click on the policy_icon.gif (266 bytes) icon to review the Plan's Benefits/Policies regarding non formulary drugs.
Not Reimbursed notreimb.gif This drug is not reimbursed by the plan.
Not Listed notlisted.gif (324 bytes) No information available for this drug. It may or may not be reimbursable.
Benefits/Policies policy_icon.gif (324 bytes) Click the icon to view the Plan's Benefits/Policies.
Generic Available generic.gif (400 bytes) The generic.gif (400 bytes) symbol indicates that the drug name it appears after is available as a generic equivalent. Health insurance providers almost always require that a generic be used if it is available.
Notes or Restrictions NOTES.gif (1094 bytes)NOTES_restrict.gif (372 bytes) Click the icon to view the Plan's notes or restrictions.

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