Drug Lists: The prescription drugs your plan covers
|Which drug list applies to your plan? If you have Individual & Family or Small Group coverage, you will find your plan’s drug list or “formulary” printed on your member ID card. Or, if you have coverage through your work, you can ask your employer directly. You can also call the Customer Support number printed on your ID card.|
Select drug lists
These lists apply to plans purchased on your state’s Health Insurance Marketplace (also known as the exchange) or if you have purchased Individual coverage off the exchange.
Please select the list for your state.
- Colorado Select Drug List
- Connecticut Select Drug List
- Indiana Select Drug List
- Kentucky Select Drug List
- Maine Select Drug List
- Missouri Select Drug List
- Nevada Select Drug List
- New Hampshire Select Drug List
- Ohio Select Drug List
- Virginia Select Drug List
- Wisconsin Select Drug List
National drug lists
These lists are for you if you get your health insurance plan from your work, another group, or if you have purchased Individual coverage off the exchange.
- National Drug List 3-Tier | (Español)
- National Drug List 4-Tier | (Español)
- National Drug List Alpha | (Español)
Generic Premium drug list
This list includes common generic versions of well-known brand-name drugs and some select brand-name ones.
Specialty drug list
This list includes specialty drugs that must be filled through a participating specialty pharmacy in order for coverage to be provided. However, this applies only if you have a specialty pharmacy network included in your benefit.
Specialty Pharmacy network lists
If you’re taking a medicine that’s on our Exclusive Specialty drug list, you may need to get your prescription filled at a specialty pharmacy in order for your drug to be covered. If you use a pharmacy that is not in the network, your medicine may not be covered and you may have to pay the full cost. Please select the list for your state.
- Colorado Specialty Pharmacy Network List
- Connecticut Specialty Pharmacy Network List
- Indiana Specialty Pharmacy Network List
- Kentucky Specialty Pharmacy Network List
- Maine Specialty Pharmacy Network List
- Missouri Specialty Pharmacy Network List
- Nevada Specialty Pharmacy Network List
- New Hampshire Specialty Pharmacy Network List
- Ohio Specialty Pharmacy Network List
- Virginia Specialty Pharmacy Network List
- Wisconsin Specialty Pharmacy Network List
How we choose the drugs on these lists
An independent group of practicing doctors, pharmacists and other health-care professionals meet often to look at new and existing drugs. They choose drugs for these lists based on a number of factors including how well they work, value to patients and safety. All drugs on these lists are approved by the Food and Drug Administration (FDA). View the latest updates from this committee.
Learn how drugs are selected for specific conditions:
Getting another drug added to the list
If you are prescribed a drug that is not listed on your plan’s drug list, you may need to pay more for it because it is not covered. You or your doctor can also fill out an Online Formulary Addition Request form to ask for an exception.
More resources that may help you
Some of the links on this page can only be viewed using Adobe Acrobat Reader. If you don’t have Adobe Acrobat Reader, you can download a free copy by clicking HERE.