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Drug Formulary

Find everything about your plan's drug formulary: comprehensive formularies, coverage criteria, OTC items and more.

What is the Drug Formulary?

The Formulary is the list of prescription drugs your plan covers. Our team of doctors and pharmacists reviews it to ensure safe, effective, quality options for your care.

Here you’ll find our comprehensive formularies with the full list of covered drugs, along with your plan’s coverage criteria.

The plan covers Formulary drugs, as long as:

  • They are medically necessary

  • The prescription is filled at a plan-network pharmacy

  • All other plan rules are met

Formulary documents

Choose the category you need and download your plan's official documents.

  • These documents are updated monthly.

Important messages

Vaccines at no cost

Our plan covers most Part D vaccines at no cost to you. For more information, call Member Services.

Insulin at $35 or less

You won’t pay more than $35 for a one-month supply of each covered insulin product, regardless of your cost-sharing tier.

Have questions? Talk to a real person.

1-833-647-9555
  • TTY 711
  • Toll-free
  • Mon–Sun, 8:00 am – 8:00 pm
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