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The Alliance formulary was developed under the direction of the Pharmacy & Therapeutics (P&T) Committee and is continually reviewed by the P&T Committee and Alliance staff. Please note that since benefits vary by line of business, some drugs or classes of drugs are not covered for some members. Please refer to the appropriate Evidence of Coverage for specific benefit restrictions.
Medications on the Maintenance Drug List can be filled for a 90-day supply.
View our formulary by:
• Therapeutic Class (PDF)
• Full print version (PDF)
• Online or downloaded to your PDA through www.epocrates.com
Epocrates is a free online drug and formulary reference that contains the latest drug and prescribing information.
Prescription Prior Authorization Form
Knox Keene lines of business (Healthy Kids, IHSS, and Medi-Cal Access Program - AIM) are required to use a standardized Prescription Drug Prior Authorization form to request prior authorizations.
If you have any questions, please contact the Alliance Pharmacy Department at (831) 430-5507.