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)


ACA High Deductible Health Plan 4-Tier


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 are 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