Our drug lists make it easy to find out if a medicine is covered under your plan. A drug list, or formulary, is a list of prescription drugs that are covered under your pharmacy benefits. Each drug list is separated into tiers based on type and cost of medications. Lower-cost and generic drugs are usually in Tiers 1
and 2. You’ll save the most money when you use Tier 1 medication.
A strong clinical foundation
through our independent pharmacy and therapeutics (P&T) review process.
Access to drugs and therapies
with clinical evidence to improve health, while trying to keep healthcare more affordable.
A total cost-of-care focus
without sacrificing access to high-quality prescription drugs.
Find out if your medicines are covered and in which tier. You can also:
This list may be for you if your health insurance plan is through an employer. Check with your employer to make sure your plan includes the CarelonRx Focused Drug List, or call the Pharmacy Member Services number on your ID card if you need assistance.
Focused Drug List Medication Alternatives, Effective 10/1/24
Focused Drug List Medication Alternatives, Effective 1/1/25
This list may be for you if your health insurance plan is through an employer. Check with your employer to make sure your plan includes the CarelonRx Advanced Drug List, or call the Pharmacy Member Services number on your ID card if you need assistance.
Advanced Drug List Medication Alternatives, Effective 10/1/24
Advanced Drug List Medication Alternatives, Effective 1/1/25
This list may be for you if your health insurance plan is through an employer. Check with your employer to make sure your plan includes the CarelonRx Guided Drug List, or call the Pharmacy Member Services number on your ID card if you need assistance.
Guided Drug List Medication Alternatives, Effective 10/1/24
Guided Drug List Medication Alternatives, Effective 1/1/25
This list may be for you if your health insurance plan is through an employer. Check with your employer to make sure your plan includes the CarelonRx Complete Drug List, or call the Pharmacy Member Services number on your member ID card if you need assistance.
One or more benefit or 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 drug lists here.
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 call the Pharmacy Member Services number on your member ID card if you need assistance.
PreventiveRx Enhanced
PreventiveRx Plus
This list includes the specialty drugs that must be filled through a participating specialty pharmacy for coverage to be provided. This list only applies if you have a specialty pharmacy network included in your benefit.
This list may be for you if you refill prescriptions through home delivery for maintenance drugs, which are used to treat long-term conditions like high blood pressure or diabetes.
