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. 

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


Preventive drugs

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)


Preventive drugs

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

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


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

Traditional 4-Tier

Preventive drugs

Aon Select 3-Tier Walgreens Employee