What's covered
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.
through our independent pharmacy and therapeutics (P&T) review process.
with clinical evidence to improve health, while trying to keep healthcare more affordable.
without sacrificing access to high-quality prescription drugs.
- View or download our latest drug list updates.
- Keep up to date on the latest drug recalls and alerts.
- Suggest a change or addition to our drug lists.
- Read more about how we evaluate care options.
- Learn about ACA Preventive Drug List.
- Learn about ACA contraceptive drug list.
- Download our brand contraceptive copay waiver form.
- Download our breast cancer copay waiver form.
Explore which drug list is covered by your plan
Focused drug list
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 7/1/23
- Focused 3 Tier Searchable | PDF
- Focused 4 Tier Searchable | PDF
- Focused 5 Tier Searchable | PDF
Advanced drug list
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 7/1/23
- Advanced 3 Tier Searchable | PDF
- Advanced 4 Tier Searchable | PDF
- Advanced 5 Tier Searchable | PDF
Guided drug list
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 7/1/23
- Guided 3 Tier Searchable | PDF
- Guided 4 Tier Searchable | PDF
- Guided 5 Tier Searchable | PDF
Complete drug list
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.
- Complete 3 Tier Searchable | PDF
- Complete 4 Tier Searchable | PDF
- Complete 5 Tier Searchable | PDF
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 drug lists here.
PreventiveRx drug list
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 Focused - PDF
- PreventiveRx Advanced - PDF
- PreventiveRx Complete - PDF
- PreventiveRx Guided - PDF
PreventiveRx Plus
Exclusive Specialty drug list
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.
Home Delivery drug list
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.