Drug Formulary, Dean Health Plan

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Dean Health Plan Drug Formularies

Dean Health Plan has developed these drug formularies to help our members and your providers choose the appropriate drugs based on your needs, coverage plan and cost of each drug.

Special note for 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. Formularies can be viewed below by clicking on the links.

Medicare Advantage

Individual & Small Employers -Affordable Care Act (ACA) policies purchased on or after Jan. 1, 2014

Prime 4-tier formulary
(Copay Plus, Classic & Value Copay members)

ACA High Deductible Health Plan 4-tier

Individual & Small Employers - Pre-ACA Transitional policies purchased before Jan. 1, 2014

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
(Small employer members)

School District Employee

Large Employers

Note: Most Dean Health Plan Large Groups use the Select 3-Tier Formulary. For more information about which formulary you are on, log in to DeanConnect.

Preferred 2-Tier
    Select 3-Tier
      High Deductible
      Health Plan 4-tier

      Federal Employees

      Traditional 4 – Tier High Deductible Health Plan 4-tier

      Aon Health Exchange Employers


      Aon Active Health Exchange
      Walgreens Employee

      See Pharmacy Benefits

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