Drug Lists: The prescription drugs your plan covers
|
Which formulary/drug list applies to your plan? If you have coverage through your work, you can ask your employer directly. |
One or more Benefit/Program Drug Lists may also apply to your plan. If your plan includes a benefit such as PreventiveRx or Exclusive Specialty, you will find your plan's applicable drug lists here. |
Formulary/Drug Lists
All of the drug lists in this section include our Drug Search (Searchable) Tool functionality
Essential Drug Lists
- Essential Drug List Medication Alternatives (3, 4 & 5 Tier plans) | (PDF)
- Essential Drug List 3-Tier (Searchable) | Essential Drug List 3-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- Essential Drug List 4-Tier (Searchable) | Essential Drug List 4-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- Essential Drug List 5-Tier (Searchable) | Essential Drug List 5-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- Essential Drug List Medication Alternatives (3, 4 & 5 Tier plans) | (PDF)
- Essential Drug List 3-Tier (Searchable) | Essential Drug List 3-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- Essential Drug List 4-Tier (Searchable) | Essential Drug List 4-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- Essential Drug List 5-Tier (Searchable) | Essential Drug List 5-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
National Drug Lists
- National Drug List Medication Alternatives (3, 4 & 5 Tier plans) | (PDF)
- National Drug List 3-Tier (Searchable) | National Drug List 3-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- National Drug List 4-Tier (Searchable) | National Drug List 4-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- National Drug List 5-Tier (Searchable) | National Drug List 5-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- National Drug List - Closed (Searchable) | (CDI PDF) | (DMHC PDF)
- National Drug List- Closed (JAA) | (National Drug List 3-Tier.pdf)
- National Drug List Medication Alternatives (3, 4 & 5 Tier plans) | (PDF)
- National Drug List 3-Tier (Searchable) | National Drug List 3-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- National Drug List 4-Tier (Searchable) | National Drug List 4-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- National Drug List 5-Tier (Searchable) | National Drug List 5-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
National Direct Drug Lists
- National Drug List Medication Alternatives (3, 4 & 5 Tier plans) | (PDF)
- National Direct Drug List 3-Tier (Searchable) | National Direct Drug List 3-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- National Direct Drug List 4-Tier (Searchable) | National Direct Drug List 4-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- National Direct Drug List 5-Tier (Searchable) | National Direct Drug List 5-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- National Drug List Medication Alternatives (3, 4 & 5 Tier plans) | (PDF)
- National Direct Drug List 3-Tier (Searchable) | National Direct Drug List 3-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- National Direct Drug List 4-Tier (Searchable) | National Direct Drug List 4-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- National Direct Drug List 5-Tier (Searchable) | National Direct Drug List 5-Tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
Select Drug Lists
This version of the Select Drug List applies to Individual plans if you purchased a plan on your state or federal Health Insurance Marketplace (also known as the exchange) or if you purchased coverage off the exchange and not through your employer:
- New! Individual 2023 Select Drug List (Searchable) | (PDF)
- Individual 2022 Select Drug List (Searchable) | (PDF)
This version of the Select Drug List applies to Small Group plans if your coverage is through a Small Group employer on, and in some cases, off the exchange.
- New! Small Group 2023 Select Drug List (Searchable) | (PDF)
- Small Group 2022 Select Drug List (Searchable) | (PDF)
Espanol
- New! Individual 2023 Select Drug List (Searchable) | (PDF)
- Individual 2022 Select Drug List (Searchable) | (PDF)
- New! Small Group 2023 Select Drug List (Searchable) | (PDF)
- Small Group 2022 Select Drug List (Searchable) | (PDF)
Contact the Pharmacy Member Services number on your ID card if you need assistance.
Traditional Open Drug Lists
- Traditional Open Drug List 3-tier (Searchable) | Traditional Open Drug List 3-tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- Traditional Open Drug List 4-tier (Searchable) | Traditional Open Drug List 4-tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- Traditional Open Drug List 5-tier (Searchable) | Traditional Open Drug List 5-tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- Traditional Open Drug List 3-tier (Searchable) | Traditional Open Drug List 3-tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- Traditional Open Drug List 4-tier (Searchable) | Traditional Open Drug List 4-tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
- Traditional Open Drug List 5-tier (Searchable) | Traditional Open Drug List 5-tier with 1a/1b (Searchable) | (CDI PDF) | (DMHC PDF)
Generic Premium Drug Lists
The Generic Premium Drug List is no longer actively marketed and only applies to members who have not been transitioned to an alternative drug list.
Benefit/Program Drug Lists
One or more Benefit/Program Drug Lists may also apply to your plan. If your plan includes a benefit such as PreventiveRx or Exclusive Specialty, you will find your plan’s applicable drug lists here. |
PreventiveRx Drug Lists
One of these lists may apply to you if your plan includes the PreventiveRx benefit (members can receive certain preventive drugs at low or no cost). Check with your employer or contact the Pharmacy Member Services number on your ID card if you need assistance.
If you have the Essential formulary/drug list, this PreventiveRx drug list may apply to you:
- PreventiveRx Plus | (Español)
- Legacy PreventiveRx Plus 2016 | (Español)
- PreventiveRx Enhanced Drug List | (Español)
If you have the National formulary/drug list, one of these PreventiveRx drug lists may apply to you:
- PreventiveRx Plus | (Español)
- Legacy PreventiveRx Plus 2016 | (Español)
- PreventiveRx Basic Drug List | (Español)
- PreventiveRx Basic Plus Drug List | (Español)
- PreventiveRx Expanded Drug List | (Español)
- PreventiveRx Enhanced Drug List | (Español)
If you have the National Direct formulary/drug list, one of these PreventiveRx drug lists may apply to you:
Anthem has aligned the National and Preferred Drug Lists. If you have the PreventiveRx Drug List (Preferred), please refer to the PreventiveRx Plus Drug List (National) above.
If you have the Traditional Open formulary/drug list, this PreventiveRx drug list may apply to you:
PreventiveRx Plus
- PreventiveRx Plus Drug List (Traditional Open) | (Español)
- PreventiveRx Enhanced Drug List | (Español)
Legacy PreventiveRx Plus 2016
For PreventiveRx Plus and if you have the Select formulary/drug list, this PreventiveRx Plus drug list may apply to you:
For Legacy PreventiveRx Plus 2016 and if you have the Select formulary/drug list, this PreventiveRx Plus drug list may apply to you:
Exclusive Specialty Drug List
This list includes the specialty drugs that must be filled through a participating specialty pharmacy in order for coverage to be provided. This list only applies if you have a specialty pharmacy network included in your benefit.
Medical Specialty Pharmacy Drug Lists
This list of specialty medications is not covered under the pharmacy benefit for certain groups.
This list of specialty medications is not covered under the medical benefit for certain groups.
Home Delivery and Rx Maintenance 90 Drug Lists
These lists may be for you if you refill prescriptions through home delivery or at a Rx Maintenance 90 pharmacy for maintenance drugs, which are used to treat long-term conditions like high blood pressure or diabetes.
View can also view our Rx Maintenance 90 pharmacies, where you can obtain up to a 90-day supply of your medicine, by going to the Rx Networks page.
How we choose the drugs on these lists
An independent group of practicing doctors, pharmacists and other health-care professionals meet often to look at new and existing drugs. They choose drugs for these lists based on a number of factors including how well they work, value to patients and safety. All drugs on these lists are approved by the Food and Drug Administration (FDA).
More resources that may help you
- Pharmacy Prior Authorization Information
- GenRx Drug List
- Drug List Addition Request Form
- Preventive Care Flier
- Preventive ACA Drug List Flier
- Brand Contraceptive Copay Waiver Form
- Breast Cancer Copay Waiver Form
- Medical Specialty Pharmacy Drug List
- ACA Contraceptive for Religious Affiliate Groups
- Home Infusion Therapy Exclusion
- Voluntary Dose Management Programs
- Voluntary Site of Care (VSOC)
Medicare Supplement Drug Lists
This list is for members who have the Medicare Supplement Senior SmartChoice plan. This plan is closed to new membership.
Some of the links on this page can only be viewed using Adobe Acrobat Reader. If you don’t have Adobe Acrobat Reader, you can download a free copy by clicking HERE