Real-Time Formulary
H2H DigitalRx checks the patient's insurance formulary at the point of prescribing. See which drugs are covered, at what tier, and select covered alternatives - all without leaving the prescription pad.
What Is Real-Time Formulary?
A formulary is the list of drugs a health plan covers, organized into cost tiers. Real-Time Formulary (RTF) queries the patient's current plan formulary electronically and returns coverage status and tier information in seconds. This differs from RTPB: RTF tells you the tier and coverage status; RTPB tells you the patient's actual out-of-pocket cost.
How RTF Works in H2H DigitalRx
Instant formulary query
Select a drug and the system checks the patient’s plan formulary in real time.
Coverage status
See whether the drug is covered, non-covered, requires prior authorization, or has quantity limits.
Tier display
View the formulary tier so you can predict the patient’s cost category (generic, preferred brand, non-preferred, specialty).
Alternative suggestions
If a drug is non-covered or high-tier, the system surfaces therapeutically equivalent covered alternatives.