Pharmacy Drug Formulary Lists

The following are lists of drug formularies that most employers and individuals may have with their health plan. To identify the tier your plan has, please refer to your Summary of Benefits and Coverage page 3.

NOTE: The information provided is a general reference of our pharmacy benefits. Not all plans or members will use the same pharmacy programs. These references are not a guarantee of coverage. Benefit determinations are based on the member’s contractual agreement. Exclusions, limitations or exceptions may apply. Benefits vary based on contract, and individual member benefits must be verified.

2018 Drug Formularies

For plans effective Jan. 1, 2018, search the following links after you open the pdf:

Please refer to the Summary of Benefits and Coverage page 3 to identify the correct drug formulary with the plan.

Member Pharmacy Resources

Reviewed by CL on January 15, 2018