Find a Prescription Drug

The Avera Health Plan pharmacy benefits covers thousands of prescription drugs to make help make your medications more affordable and convenient. Coverage may vary by your insurance plan and its pharmacy benefits. The cost of a prescription also depends on the drug’s tier level, known as a drug formulary.

Current Members

If you already have health insurance with Avera Health Plans, log in to access details on your pharmacy benefits – and to determine if certain medications or services require a preauthorization.

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Not a Member Yet?

If you’re not an Avera Health Plans member yet, check out this list of commonly covered drugs (the formulary) from the selections below.

What is a drug formulary?

What is a drug formulary?

The drug formulary lists include both generic and brand-name medications approved by the U.S. Food & Drug Administration (FDA). It includes covered prescription drugs approved for use for specific treatments and dispensed through participating pharmacies. Avera Health Plans works with a team of health care providers to choose drugs that provide quality treatment. We cover drugs on the drug formulary that are:

  • Medically necessary
  • Approved by the FDA
  • Filled at a participating pharmacy

Preventive Drugs

These Tier 0 and Tier 1 drugs are usually generics and are covered at no cost to you.

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3-Tier Formulary Drugs

These prescriptions include both brand and generic drugs. Generic drugs have the same active ingredient as name-brand prescriptions

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4-Tier Formulary Drugs

These medicines are preferred brand drugs. Your out-of-pocket costs will be higher than drugs in lower tiers.

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6-Tier Formulary Drugs

These include both name brand and generic specialty prescriptions.

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Hybrid 6-Tier Formulary

These include both name brand and generic specialty prescriptions.

See List

Tips to Maximize Your Pharmacy Benefits

  1. Choose a participating pharmacy.
  2. Pay the pharmacy your prescription’s co-pay and co-insurance. If the retail cost is less than the co-pay, you’ll pay the full retail amount.
  3. Show your member ID card at the pharmacy each time you fill a prescription.
  4. Use generic drugs whenever possible.
  5. Get your prescriptions by mail order. Fill out the Avera mail order request form to get started.
Pharmacy Benefits

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Check to see if what doctors, providers and locations are considered in-network with Avera Health Plans. Learn about vision and dental plan providers.

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