Member drug formularies
Our formularies (drug listings) will help you and your providers choose the right medication based on need, coverage plan, and drug cost.
Not sure which formulary is yours? Look up your member benefits.
Find out about our formulary management procedures.
Special notes:
- Members on Health Savings Account (HSA) eligible High Deductible Health Plans (HDHP): Beginning with your first renewal on or after Jan. 1, 2018, you will be transitioned to our High Deductible Health Plan formulary.
- Members enrolled in a Smart Plan benefit design, please reference the Select 4-Tier formulary.
- The Preventive Drug List (PDL) only applies to the following plans:
- Pre-ACA Individual & Small Group Employers
- Large Group Employer Plans
- School District Employer Plans
- Aon Health Exchange Employer Plans
- FEHB
Learn more about the Medicare Advantage drug formulary.
Individual & Small Employers - Affordable Care Act (ACA) policies purchased on or after Jan. 1, 2014
| Prime 4-Tier Marketplace Formulary (Copay Plus, Classic & Value Copay members) 2024 |
Preventive drugs
- 2024 preventive drug list, effective 1/1/24
| Preferred 3-Tier (Individual members) |
High Deductible Health Plan 3-Tier (Individual members) |
Select 3-Tier (Small employer members) |
High Deductible Health Plan 4-Tier |
Preventive drugs
- 2024 Preventive drug list, effective 1/1/24
- Expanded preventive drug list, effective upon your 2024 renewal date
| Preferred 2-Tier | Preferred 3-Tier | Select 3-Tier | Select 4-Tier |
|
Note: Most Dean Health Plan large groups use the Select 3-Tier formulary. For more information about which formulary you're on, log in to DeanConnect.
Preventive drugs
- 2024 preventive drug list, effective 1/1/24
- Expanded preventive drug list, effective upon your 2024 renewal date
| Preferred 2-Tier | Select 3-Tier | High Deductible Health Plan 4-Tier |
Select 4-Tier |
| Traditional 4-Tier |