Member 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.

Not sure which formulary is yours? Look up your member benefits

Find out about our formulary management procedures.

Special Notes:

  • For member 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.
  • For members enrolled in a Smart Plan benefit design, please reference the Select 4-Tier formulary.

Learn more about the Medicare Advantage drug formulary. 

Prime 4-Tier Marketplace Formulary (Copay Plus, Classic & Value Copay members)

2022
ACA High Deductible Health Plan 4-Tier

2022

View preventive drug list effective 1/1/2022.

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)

View preventive drug list effective 1/1/2022.

Preferred 2-Tier

Preferred 3-Tier

Select 3-Tier

Select 4-Tier

High Deductible Health Plan 4-Tier

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.

View preventive drug list effective 1/1/2022.

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

Traditional 4-Tier

View preventive drug list effective 1/1/2022.

Aon Select 3-Tier Walgreens Employee