What is a "formulary" in the context of health insurance?

In the context of health insurance, a formulary refers specifically to a list of prescription medications that are covered by a health insurance plan. This list usually categorizes drugs by their tiers, which can influence how much a policyholder has to pay out-of-pocket for each medication. Typically, medications on lower tiers have lower copayments or deductibles, while those on higher tiers may require higher out-of-pocket costs. Understanding the formulary is crucial for policyholders to manage their healthcare expenses effectively and to ensure that they have access to necessary prescriptions while minimizing their costs.

The other options describe different aspects of health insurance; for example, a list of healthcare providers covered under a plan refers to the network of doctors and hospitals that policyholders can use. The claim submission procedures document would outline how policyholders can file their claims for reimbursement. A summary of benefits provides an overview of what is covered under a plan, such as coverage limits, deductibles, and copayments, but does not specifically address prescription drug coverage like the formulary does.