Pharmacy overview
Formulary tools
Drug formulary search: Search for drugs by name or therapeutic class.
Epocrates downloadable formulary: Check formulary status and prior authorization criteria for medications covered under the pharmacy benefit.
Drug formulary exception request: Request coverage for medications requiring prior authorization and for drugs not included in the formulary. To submit a formulary exception on behalf of a patient, call the Drug Benefit Help Desk at 1-800-729-1174, option 1, or fax to 1-866-439-0050. Patients can also submit a formulary exception request via the online form on the secure member website.
Quantity Limits (QL) drug list: Medications covered under the pharmacy benefit with quantity limits:
Kaiser Permanente commercial QL drug list (PDF)
Chronic high-dose opioid therapy Prior authorization form (PDF): Effective 10/1/18, commercial members on chronic opioid therapy >=90 mg MED/day will require prior authorization to ensure their care plan supports safe use of opioids.
Prior authorization for injectable drugs
Injectable drugs covered under the medical benefit and administered by a health care professional in an office or home infusion setting may require prior authorization and clinical review.
For drug lists and site of care policy, see:
- Injectable drugs requiring prior authorization
- Site of Care Policy (PDF)
- Site of Service Policy (PDF)
We have also developed a biosimilar FAQ (PDF) for your reference, which includes Kaiser Permanente’s preferred biosimilar products.
Kaiser Permanente Washington specialty pharmacy
Our specialty pharmacy works closely with patients and providers to manage certain medications used to treat serious chronic conditions. For more information, see Specialty pharmacy.
Self-administered medications
The self-administered drug policy (PDF) includes the criteria used to identify that a medication is self-administered and provides a list of medications that are not covered under the medical benefit.
Limited distribution medications
Overview of the process for prescribing limited distribution medications for Kaiser Permanente Members. Includes Kaiser Permanente's Limited Distribution Preferred Pharmacy list. For more information, see Limited distribution medications.
Clinician prescribing tools
Evidence-based reference materials designed to help you care for your patients.
Pharmacy drug benefit help desk
Pharmacy news
View our quarterly newsletter, Pharmacy news.
Pharmacy services for members
For information about Kaiser Permanente pharmacy networks, mail-order refills, and other pharmacy services, see Pharmacy services for members.