Terms of Service

Last updated: April 1, 2026 · Effective: April 1, 2026

Plain English summary: FormCheckRx is a professional formulary reference tool built for healthcare professionals. It provides accurate Michigan Medicaid formulary information to support your work — the same way a drug database, formulary PDF, or plan website does. You remain the professional. You exercise judgment. We give you the information to do your job faster and more accurately.

1. What FormCheckRx Is

FormCheckRx is a Medicaid drug formulary reference platform built for healthcare professionals — care coordinators, pharmacists, social workers, discharge planners, and physician offices. It provides formulary status, prior authorization requirements, covered alternatives, and related coverage information across Michigan Medicaid managed care plans.

FormCheckRx is a reference tool, in the same category as a drug formulary PDF, a plan's online formulary search tool, or a clinical drug database. It is designed to give healthcare professionals accurate, fast access to the formulary information they need to do their jobs. The information it provides is accurate and is based on the Michigan Medicaid Common Formulary (Single Preferred Drug List).

How to use FormCheckRx correctly: Use it the same way you would use any professional reference — to look up formulary status, find covered alternatives, check PA requirements, and identify carve-out drugs. Apply your professional judgment to your specific patient situation, as you would with any reference tool. Final coverage payment is determined by the plan's PBM at the point of claim.

2. Scope of the Information

FormCheckRx provides information based on the Michigan Medicaid Common Formulary (SPDL) — the shared formulary that governs all five Michigan Medicaid managed care plans. This is the same document your plan websites and formulary PDFs are based on.

One important distinction: FormCheckRx is a reference tool, not a live claims adjudication system. When a pharmacist submits a claim, the plan's PBM processes it against the current formulary in real time. FormCheckRx reflects the formulary as maintained in our system — which is based on the current SPDL and is updated regularly. For drugs where exact coverage is time-sensitive — such as drugs undergoing a formulary tier change — we recommend confirming directly with the plan before final clinical action.

Formularies update quarterly. FormCheckRx includes a quarterly update disclosure on every result. For routine formulary questions, FormCheckRx is a reliable and accurate reference. For edge cases or recently changed drugs, verify with the plan.

3. Who This Service Is For

FormCheckRx is designed for licensed and trained healthcare professionals and the organizations that employ them. It is not designed as a patient self-service tool. Healthcare professionals using FormCheckRx are expected to apply their training and professional judgment in conjunction with the information provided.

If you are a patient or member seeking information about your prescription coverage, FormCheckRx can help you understand general formulary status — but we recommend discussing your specific situation with your pharmacist, prescriber, or plan directly.

4. Appropriate Reliance

FormCheckRx is built to be relied upon for formulary reference purposes. That is its purpose. The following clarifies what appropriate reliance looks like:

Appropriate: Using FormCheckRx to determine a drug's formulary tier and identify covered alternatives before a prescription is written
Appropriate: Using FormCheckRx to verify PA requirements before submitting a prior authorization request
Appropriate: Using FormCheckRx to identify whether a drug is a carve-out and should be billed through Fee-for-Service rather than the managed care plan
Appropriate: Using FormCheckRx results as part of a discharge planning workflow to confirm medication coverage
Not a substitute for: A live claims adjudication system for determining real-time payment approval at the pharmacy counter
Not a substitute for: Medical advice from a licensed prescriber regarding drug appropriateness for a specific patient

5. No Patient Information

FormCheckRx accepts drug names only. No patient name, member ID, date of birth, diagnosis, or any Protected Health Information (PHI) should be entered into FormCheckRx. The platform is not designed to process patient-specific data.

Under 45 CFR §160.103, FormCheckRx is not a covered entity or business associate under HIPAA. No Business Associate Agreement is required to use this service.

6. Subscription and Payment

Free Plan: FormCheckRx offers a limited free tier with 3 searches per day. No credit card required.

Paid Plans: Individual ($19.99/month, 100 searches/day), Small Team ($79.99/month, 5 users, 500 searches/day), Organization ($259.99/month, 20 users, 2,000 searches/day). All payments are processed by Stripe. Paid plans include a 14-day free trial.

Daily Search Caps: All plans — including paid plans — have daily search caps. Caps are enforced server-side to prevent abuse and control costs. Users who reach their cap receive a notification. Temporary increases are available for documented high-volume needs.

Cancellation: You may cancel at any time. Cancellation takes effect at the end of the current billing period. We do not provide refunds for partial months except where required by law.

7. Intellectual Property

The FormCheckRx platform, including its multi-agent framework architecture, prompt engineering, user interface, and documentation, is proprietary and protected by copyright and trade secret law. The underlying Michigan Medicaid formulary data is derived from publicly available government sources (MDHHS) and is not proprietary to FormCheckRx.

8. Limitation of Liability

FormCheckRx provides accurate formulary reference information and stands behind the quality of that information. At the same time, like any reference tool, it cannot guarantee that every result reflects the most current formulary status for every drug at every moment — formularies change, and real-time adjudication is performed by the plan's PBM, not by a reference tool.

TO THE MAXIMUM EXTENT PERMITTED BY LAW, FORMCHECKRX'S LIABILITY FOR ANY CLAIM ARISING FROM USE OF THE SERVICE IS LIMITED TO THE AMOUNT YOU PAID IN THE 12 MONTHS PRECEDING THE CLAIM. FORMCHECKRX IS NOT LIABLE FOR INDIRECT, INCIDENTAL, OR CONSEQUENTIAL DAMAGES.

9. Termination

We may suspend or terminate access for violation of these Terms, non-payment, or suspected fraudulent or abusive activity. You may terminate your account at any time by cancelling your subscription.

10. Governing Law

These Terms are governed by the laws of the State of Michigan. Disputes shall be resolved in Michigan courts.

11. Changes to Terms

We may update these Terms with 30 days notice to subscribers before material changes take effect. Continued use constitutes acceptance.