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List of Drugs (Formulary)

Our list of drugs (formulary) shows the drugs we cover. The list includes:

  • Medicare Part D drugs
  • Some Medicaid covered prescription and over-the-counter drugs and items

In general, we cover drugs if they are medically necessary. Drugs on the list of drugs are covered when you use our network pharmacies or mail order program for maintenance drugs. Maintenance drugs are drugs you take for a chronic or long-term condition. Some drugs we cover have limits or other rules.

The Pharmacy and Therapeutics Committee, our team of independent healthcare experts, reviews and approves the list of drugs. We don’t include all drugs. Some drugs may not be covered or are excluded. Other drugs are not on the list because of clinical and cost reasons.

How do I search for a drug in the List of Drugs?

You can search for a drug by using the search tool, alphabetical index or by medical condition.

Search Tool: Open the drug list (PDF). Hold down the “Control” (Ctrl) and “F” keys. When the search box appears, type the name of your drug. Press the “Enter” key.

Alphabetical Index: The index at the end of the PDF lists the names of generic and brand name drugs from A to Z. Once you find a drug name, go to the page number listed to see if the drug is covered.

Medical Condition: The drugs are grouped into categories by type of medical condition that they are used to treat. For example, “Cardiovascular Agents – Drugs to Treat Heart and Circulation Conditions.” If you know what your drug is used for look through the list to find the category. Then look under the category for your drug.

Updated 10/01/2021:

List of Drugs Change Notice

Drugs may be added or removed from our list of drugs during the year. We will tell you 60 days before the following changes are made to the list of drugs:

  • Remove a drug from the list
  • Change drug requirements
  • Move a drug to a higher cost sharing tier

If the Food and Drug Administration (FDA) or the drug’s maker says a drug is not safe, it will be removed from our list of drugs right away. To view the changes, open the PDF list below.

If you have questions about our list of drugs, or want the most recent version, contact Member Services. We are here to help.