What does "nonformulary drugs" refer to?

Nonformulary drugs refer to medications that are not included on a specific health insurance plan's formulary list. These drugs typically fall outside the range of medications that the insurance provider has agreed to cover under their policy. When a medication is classified as nonformulary, it means that patients may need to pay full price for the medication or go through a prior authorization process to obtain coverage. This is significant for patients and healthcare providers in managing treatment options and costs. Understanding the implications of a nonformulary designation helps in navigating insurance plans and selecting appropriate medications for patients.

The other options describe different categories of medications but do not accurately define what nonformulary drugs are. For instance, expired drugs simply refer to medications that have surpassed their expiration date, while over-the-counter drugs are those available for purchase without a prescription. Controlled substances, while regulated differently, do not inherently indicate whether they are covered by insurance or included in a formulary.