Provider Pharmacy Information
As A Valuable Provider You Can
Make the most of Anthem’s pharmacy information by searching your patients drug list, find a pharmacy and learn about medication costs.
Drug List
Want information about a particular medication? Search or download the most up-to-date drug information for your plan.
Clinical Criteria
Anthem’s clinical criteria gives providers the necessary data to prescribe the most effective medications for their patients.
Drug Alerts
Anthem's drug alerts offer a wealth of content explaining how individual drugs impact health and healthcare.
On-The-Go Drug List Information Access
The Sydney Health app makes it easy to log in to your account, look up your plan’s drug list and check medication costs.
Frequently Asked Questions
The drug list, also called a formulary, is a list of prescription medicines your plan covers. It includes hundreds of brand-name and generic drugs approved by the U.S. Food & Drug Administration (FDA).
The drugs are listed in alphabetical order based on the name of their drug class, also called therapeutic class. You can search the PDF drug list by typing in the name of the drug you’re looking for.
The Notes column will tell you if you need preapproval before you can take the drug (called prior authorization or PA), or if you need to try other drugs first for your treatment (called step therapy or ST).
Your plan’s network includes over 67,000 pharmacies nationwide, with two levels of coverage:
- Level 1: Your plan’s network has nearly 26,000 preferred pharmacies, including chains like CVS, Target, Kroger, Walmart, Albertson’s, Strategic Health Alliance, Giant Eagle, and Costco. Preferred pharmacies are those we work with to help you save on medication costs, including copay and co-insurance.
- Level 2: You can also fill prescriptions at any of the plan’s 40,000+ non-preferred Level 2 pharmacies, but you may pay more. If you regularly take medication for ongoing conditions like asthma, diabetes, or high cholesterol, you will need to set up 90-day supplies at a pharmacy in the Rx Maintenance 90 network, including CVS retail or through home delivery. This is a requirement, but it also helps you save time and money on refills.
Home Delivery
If there are medications you take regularly, you can save time and money with our home delivery service. CarelonRx Mail will deliver up to 90-day supplies with free standard shipping.
Learn more about 90-day delivery.
Specialty Pharmacy
If you have a health condition that requires specialty medicine, such as those you take by injection or infusion, or that need special handling, you will need to order through CarelonRx Specialty Pharmacy. You may also choose other in-network specialty pharmacies.
To view a list of covered specialty drugs that require a network specialty pharmacy, please visit our Drug List, and select the Exclusive Specialty Drug List.
The drug list, also called a formulary, is a list of prescription medicines your plan covers. It includes hundreds of brand-name and generic drugs approved by the U.S. Food & Drug Administration (FDA).
The drugs are listed in alphabetical order based on the name of their drug class, The drugs are listed in alphabetical order based on the name of their drug class, also called therapeutic class. You can search the PDF drug list by typing in the name of the drug you’re looking for.
The Notes column will tell you if you need preapproval before you can take the drug (called prior authorization or PA), or if you need to try other drugs first for your treatment (called step therapy or ST).
Your plan’s network includes over 67,000 pharmacies nationwide, with two levels of coverage:
- Level 1: Your plan’s network has nearly 26,000 preferred pharmacies, including chains like CVS, Target, Kroger, Walmart, Albertson’s, Strategic Health Alliance, Giant Eagle, and Costco. Preferred pharmacies are those we work with to help you save on medication costs, including copay and co-insurance.
- Level 2: You can also fill prescriptions at any of the plan’s 40,000+ non-preferred Level 2 pharmacies, but you may pay more. If you regularly take medication for ongoing conditions like asthma, diabetes, or high cholesterol, you will need to set up 90-day supplies at a pharmacy in the Rx Maintenance 90 network, including CVS retail or through home delivery. This is a requirement, but it also helps you save time and money on refills.
Home Delivery
If there are medications you take regularly, you can save time and money with our home delivery service. CarelonRx Mail will deliver up to 90-day supplies with free standard shipping.
Learn more about 90-day delivery.
Specialty Pharmacy
If you have a health condition that requires specialty medicine, such as those you take by injection or infusion, or that need special handling, you will need to order through CarelonRx Specialty Pharmacy. You may also choose other in-network specialty pharmacies.
To view a list of covered specialty drugs that require a network specialty pharmacy, please visit our Drug List, and select the Exclusive Specialty Drug List.
The drug list, also called a formulary, is a list of prescription medicines your plan covers. It includes hundreds of brand-name and generic drugs approved by the U.S. Food & Drug Administration (FDA).
The drugs are listed in alphabetical order based on the name of their drug class, also called therapeutic class. You can search the PDF drug list by typing in the name of the drug you’re looking for.
The Notes column will tell you if you need preapproval before you can take the drug (called prior authorization or PA), or if you need to try other drugs first for your treatment (called step therapy or ST).
Your plan’s network includes over 67,000 pharmacies nationwide, with two levels of coverage:
- Level 1: Your plan’s network has nearly 26,000 preferred pharmacies, including chains like CVS, Target, Kroger, Walmart, Albertson’s, Strategic Health Alliance, Giant Eagle, and Costco. Preferred pharmacies are those we work with to help you save on medication costs, including copay and co-insurance.
- Level 2: You can also fill prescriptions at any of the plan’s 40,000+ non-preferred Level 2 pharmacies, but you may pay more. If you regularly take medication for ongoing conditions like asthma, diabetes, or high cholesterol, you will need to set up 90-day supplies at a pharmacy in the Rx Maintenance 90 network, including CVS retail or through home delivery. This is a requirement, but it also helps you save time and money on refills.
Home Delivery
If there are medications you take regularly, you can save time and money with our home delivery service. CarelonRx Mail will deliver up to 90-day supplies with free standard shipping.
Learn more about 90-day delivery.
Specialty Pharmacy
If you have a health condition that requires specialty medicine, such as those you take by injection or infusion, or that need special handling, you will need to order through CarelonRx Specialty Pharmacy. You may also choose other in-network specialty pharmacies.
To view a list of covered specialty drugs that require a network specialty pharmacy, please visit our Drug List, and select the Exclusive Specialty Drug List.
The drug list, also called a formulary, is a list of prescription medicines your plan covers. It includes hundreds of brand-name and generic drugs approved by the U.S. Food & Drug Administration (FDA).
Yes, this is a complete listing of all the drugs on the drug list. But it’s possible a drug(s) on this list may not be covered, depending on your plan’s design. Your coverage has limitations and exclusions, which means there are certain conditions that determine what’s covered by your plan and what isn’t.
To find out more, read your Certificate/Evidence of Coverage or your Summary Plan Description, which you got when you signed up for your plan.
The drugs are listed in alphabetical order based on the name of their drug class, also called therapeutic class. You can search the PDF drug list by typing in the name of the drug you’re looking for.
The Notes column will tell you if you need preapproval before you can take the drug (called prior authorization or PA), or if you need to try other drugs first for your treatment (called step therapy or ST).
Not What You Are Looking For?
Anthem offers specific pharmacy information for our members, employers, brokers, and providers. If you need more from us, check out the
Pharmacy Information Overview.