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Lista de medicamentos cubiertos (Formulario)

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 (Formulary) 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 either the drug search tool by clicking the link below or by opening the List of Drugs (Formulary) PDF document below. Each option gives you a complete list of covered drugs and any restrictions or limits. The search tool also shows you covered drug alternatives. 

The PDF document lists drugs by medical condition and alphabetically within the index. To search for your drug in the PDF, hold down the “Control” (Ctrl) and “F” keys. When the search box appears, type the name of your drug. Press the “Enter” key. You also have the option to print the PDF drug list. The drug list is updated monthly.

Updated Updated 10/01/2021:

List of Drugs - Search Tool

List of Drugs by Language

  • List of Drugs - English (PDF)
  • List of Drugs - Spanish (PDF) 

How to request a List of Drugs by mail

  • How to request a List of Drugs by mail - English (PDF)
  • How to request a List of Drugs by mail - Spanish (PDF) 

List of Drugs Change Notice- Coming February 2022

Drugs may be added or removed from our list of drugs during the year. Generally, we will tell you 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.

  • 2021 List of Drugs Change Notice (PDF)

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