HMSA Formulary†,*
To view the current drug formulary, please click the links below:
- HMSA's Metallic Drug Formulary - 07/01/2026 [PDF]
- HMSA's Metallic Drug Formulary - 07/01/2026 [JSON] (Machine Readable File)
Metallic Formulary Coverage Codes
| 106 107 109 112 114 115 118 119 121 122 123 124 |
623 624 625 626 627 628 629 631 632 661 796 |
875 877 878 879 882 883 884 890 891 892 893 894 895 896 |
907 908 909 910 911 912 913 914 915 916 917 918 919 |
920 921 922 923 924 925 926 927 928 929 |
930 931 932 933 934 935 936 989 991 992 998 |
† Brand drugs not listed in the formulary should be considered OTHER BRAND.
* The online HMSA Drug Formulary is updated quarterly. Providers may request a CD version of the formulary by contacting HMSA Provider Services.
Access previous versions of the Metallic drug formulary.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform |