Which statement accurately describes a formulary?

• A. A list of medications not covered by the plan, regardless of CMS guidelines.
• B. A list of medications covered by the benefit plan, based on CMS guidelines, and developed in collaboration with providers and pharmacists.
• C. A schedule of physician visits.
• D. A catalogue of medical devices.

Answer: (B)

A formulary is a plan’s approved list of medications that are covered for beneficiaries, chosen to reflect evidence-based practice, safety, effectiveness, and cost considerations, and developed in collaboration with clinicians and pharmacists in line with CMS guidelines. That’s why the statement describing a list of medications covered by the benefit plan, based on CMS guidelines and created with input from providers and pharmacists, is the best fit. The other options describe things outside the scope of a formulary: a list of medications not covered, a schedule of physician visits, or a catalogue of medical devices. A formulary focuses on which drugs are covered and how they are managed (tiers, prior authorization, etc.), not on what is excluded, nor on visits or devices.