Covered Drugs
Your plan comes with a medication guide. It lists all the drugs your plan covers, plus any special rules you’ll need to follow with certain medications.
Each plan has its own medication guide, so be sure the one you look at matches the plan you are shopping for or are already enrolled in.
If you are already enrolled in a plan: Have your ID card handy and log in to your member account to view the medication guide that is specific to the plan you are enrolled in.
If you are shopping for you and your family, choose a medication guide that matches the plan you are looking at.
* Includes plans available on or off the Health Marketplace.
If you are selecting a plan through your small-group* employer (fewer than 50 full-time employees), choose the medication guide that matches the plan name in your enrollment kit.
If you are selecting a plan through your large-group* employer (more than 50 full-time employees), choose the medication guide that matches the plan name in your enrollment kit.
* If you are not sure if your group is a small-group or large-group, please ask your HR administrator.
Medication Guides for Medicare Eligibles:
The Medication Guides are updated monthly. Links are included below to the Medicare approved Formularies and the most recent updates to the printed version of the Medication Guide for Medicare Eligibles.
Please have your patient refer to the pharmacy endorsement or rider issued with his or her contract, Evidence of Coverage, member handbook or certificate of coverage to determine whether a particular medication listed is covered. If your patient is unsure about particular coverage/benefits or has questions about the Medication Guide, please have the member call the Customer Service number on his or her ID card. The fact that a particular drug is listed in the guide does not necessarily mean that it is covered under each member's contract, Evidence of Coverage or certificate of coverage.