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Search Capabilities

Search the Formulary for Standard and Performance Plans by medication name or type. Search results include:

  • The drug tier, which determines the copay (amount) or coinsurance (percentage) that the member will be required to pay for the drug;
  • Any restrictions for the drug, such as prior authorization, quantity limits or step therapy requirements;
  • The effective date of the formulary and the date it was last updated.

Mobile device users should open the tool in a new window for the best search experience.

You may also download and print the  Formulary - Standard and Performance Plans.

Need to request prior authorization? Download our prior authorization form.

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