Pharmacy formularies
Use the links below to confirm whether or not a specific drug is on our list of covered drugs.
2024 formularies
For coverage dates starting 01/01/2024, please refer to the following lists.
- Value 3-Tier: Searchable List | PDF
- Value 4-Tier: Searchable List | PDF
- Premium 3-Tier: Searchable List | PDF
- Premium 4-Tier: Searchable List | PDF