Providers can now review the Q2 2026 Scripius/Select Health formulary updates. These changes include coverage updates, preauthorization changes, step therapy requirements, quantity limits, specialty drug updates, and medical benefit determinations.
Key effective dates
Updates take effect between April 1, 2026, and August 1, 2026, depending on the medication, formulary, state, and plan type.
Categories of changes
- New coverage: Several medications moved from not covered to covered formulary positions with requirements added such as preauthorization, quantity limits, or step therapy.
- Preauthorizations no longer required: Preauthorization requirements were removed for select medications.
- Clinical efficiency: Some medications were removed from our formularies because there are higher-value alternatives available.
- Therapy areas: Diabetes, oncology, vaccine, inflammatory, rare disease, Parkinson’s disease, and weight loss therapies are among the therapeutic areas with notable updates.
How formulary decisions are made
The contents of our formularies are typically reviewed each month by a team of doctors and pharmacists who form our Pharmacy and Therapeutics Committee. This team reviews and evaluates the clinical efficacy, safety, and cost effectiveness of medications and may remove drugs from, or add drugs to, our covered drug lists.
While Select Health/Scripius refer to many of the drugs, pharmacies, and services in this document by their respective trademarks, they do not own those trademarks. In listing these drugs, pharmacies, and services, Select Health/Scripius does not endorse or sponsor any drug, manufacturer, or supplier. These drugs, manufacturers, and suppliers are not affiliated with Select Health/Scripius and do not endorse or sponsor any Select Health/Scripius services or plans.