Certain groups use these lists instead of the lowest net cost formulary. If you are unsure which lists apply to you, please contact your human resources department.

Premium Formulary List

The premium formulary list includes many of the drugs your plan covers. The drugs on this list are generic or preferred brands to treat many common conditions. If your drug is not on this list, review the premium formulary excluded drug list to ensure your drug is not excluded. If a brand drug is not on either list, it is probably a non-preferred brand drug.

Premium Formulary Excluded Drug List

This is a list of drugs we exclude from coverage and some covered alternatives to discuss with your doctor. View the premium formulary excluded drug list here.

Affordable Care Act (ACA) Preventive Services

Preventive drugs and services help you stay healthy. Most plans now cover the drugs on this list at no cost to you. View the ACA preventive services list here.

Quantity Management

Some members have this program as part of their premium formulary drug list. Learn how quantity management works and which drugs have quantity limits.

Step Therapy

Some members have this program as part of their premium formulary drug list. Step therapy requires that before you have coverage for second-choice drugs in certain categories, you must first try one or more first-choice drugs in that category. Learn how step therapy works and which drugs are included.

Specialty Drug List

Specialty drugs are prescription medications that are used to treat complex or chronic medical conditions like cancer, rheumatoid arthritis, multiple sclerosis and hepatitis, just to name a few. Depending on your plan, you may pay a different copayment or coinsurance for drugs on the specialty drug list.

Some members are subject to separate management programs for specialty drugs that are covered under their medical benefits.

Prior Authorization

Some members have this program as part of their premium formulary drug list. Drugs in this program require prior authorization before you have coverage. Learn how prior authorization works and which drugs are included.