Premium Formulary - Drug Lists

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 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.

Non-Discrimination Statement and Foreign Language Access

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.

Quantity Management

Some members have this program as part of their Premium Formulary Drug List. Learn how the 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 the Step Therapy works and which drugs are included.

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 the Prior Authorization works and which drugs are included.

Drug Cost Tool

Please log in to your My Health Toolkit account to view drug pricing information.