Drug Search
To find out which formulary you are on, log on to My Account, click the Coverage tab and select Coverage Details. If you do not see your formulary listed below, check your summary of benefits or visit our Group site.
Formulary
A formulary, also called a drug list, is a list of prescription drugs your insurance plan covers. It typically includes the most commonly prescribed drugs—both brand name and generic—and shows how much you pay for each drug. The purpose of a formulary is to help you contain costs and ensure quality of care.
Please note, the formularies listed below are not all-inclusive lists and are subject to change. To search for a specific drug, open the PDF and click “CTRL” and “F” at the same time.
Select Year:
2022 Plan Year
| Formulary 3 |
|---|
| Formulary 3
(5-Tier: generic, preferred brand, non-preferred brand, preferred brand specialty, non-preferred brand specialty) |
| Formulary 3 Preferred Drug List
The CareFirst Preferred Drug List represents a summary of Formulary 3 and is a guide to help you identify drugs that are both clinically appropriate and cost-effective. |
| Preventive Drug List
Preventive services help you stay healthy. This list indicates which drugs, health-related products or vaccines may be covered as preventive services at no cost to you. This means you may not have to pay a copay or coinsurance, even if you haven’t met your deductible. |
| Formulary 3 Prescription Guidelines
This is a list of drugs that may be covered through your prescription plan and is subject to utilization management such as prior authorization, quantity limits or step therapy. |
| Specialty Drug List
This is a list of specialty drugs that may be covered through either your prescription or medical plan. Specialty drugs are medications that may be used to treat rare health conditions and require special handling, administration or monitoring. |
| HealthyBlue Select Generics
This is a list of preventive drugs used to treat certain chronic conditions that are not subject to deductible and have a $0 copay for HealthyBlue CDH members. |
| Formulary 4 |
|---|
| Formulary 4, 2-Tier
(2-Tier: $0 drugs, generic drugs, brand drugs) |
| Preventive Drug List
Preventive services help you stay healthy. This list indicates which drugs, health-related products or vaccines may be covered as preventive services at no cost to you. This means you may not have to pay a copay or coinsurance, even if you haven’t met your deductible. |
| Specialty Drug List
This is a list of specialty drugs that may be covered through either your prescription or medical plan. Specialty drugs are medications that may be used to treat rare health conditions and require special handling, administration or monitoring. |
| Prescription Guidelines - Formulary 4
This is a list of drugs that may be covered through your prescription plan and is subject to utilization management such as prior authorization, quantity limits or step therapy. |
| Formulary 4 Quick Reference Guide |
| HealthyBlue Select Generics
This is a list of preventive drugs used to treat certain chronic conditions that are not subject to deductible and have a $0 copay for HealthyBlue CDH members. |
| Exchange Formulary
A formulary is a list of covered prescription drugs. |
| Abridged Exchange Formulary
The abridged formulary is an abbreviated version of the Exchange Formulary. |
| Exchange Preventive Drug List
Preventive services help you stay healthy. This list indicates which drugs, health-related products or vaccines may be covered as preventive services at no cost to you as part of the Affordable Care Act (ACA). This means you may not have to pay a copay or coinsurance, even if you haven’t met your deductible. |
| Prescription Guidelines - Exchange
This is a list of drugs that may be covered through your prescription plan and is subject to utilization management such as prior authorization, quantity limits or step therapy. |
| Specialty Drug List
This is a list of specialty drugs that may be covered through either your prescription or medical plan. Specialty drugs are medications that may be used to treat rare health conditions and require special handling, administration or monitoring. |
| Diabetes Drug & Supply List for DC Standard Plans (effective 1/1/23)
This is a list of diabetic supplies and prescription drugs that are not subject to the deductible and have a $0 copay for members enrolled in DC Standard Plans with a primary diagnosis of Type 2 diabetes. |
| Exchange Formulary
A formulary is a list of covered prescription drugs. |
| Abridged Exchange Formulary
The abridged formulary is an abbreviated version of the Exchange Formulary. |
| Exchange Preventive Drug List
Preventive services help you stay healthy. This list indicates which drugs, health-related products or vaccines may be covered as preventive services at no cost to you as part of the Affordable Care Act (ACA). This means you may not have to pay a copay or coinsurance, even if you haven’t met your deductible. |
| Prescription Guidelines - Exchange
This is a list of drugs that may be covered through your prescription plan and is subject to utilization management such as prior authorization, quantity limits or step therapy. |
| Specialty Drug List
This is a list of specialty drugs that may be covered through either your prescription or medical plan. Specialty drugs are medications that may be used to treat rare health conditions and require special handling, administration or monitoring. |
| Diabetes Drug & Supply List for DC Standard Plans (effective 1/1/23)
This is a list of diabetic supplies and prescription drugs that are not subject to the deductible and have a $0 copay for members enrolled in DC Standard Plans with a primary diagnosis of Type 2 diabetes. |
| Drugs Requiring Prior Authorization - Formulary 2
This is a list of drugs that require a medical necessity prior authorization to be covered by your prescription drug plan. |
| Formulary 2, 3 Tier
(3-Tier: generic, preferred brand, non-preferred brand) |
| Formulary 2, 4 Tier
(4-Tier: generic, preferred brand, non-preferred brand, self injectables) |
| Formulary 2 Preferred Drug List
The CareFirst Preferred Drug List represents a summary of Formulary 2 and is a guide to help you identify drugs that are both clinically appropriate and cost-effective. |
| HealthyBlue Select Generics
This is a list of preventive drugs used to treat certain chronic conditions that are not subject to deductible and have a $0 copay for HealthyBlue CDH members. |
2021 Plan Year
| Formulary 3 |
|---|
| Formulary 3
(5-Tier: generic, preferred brand, non-preferred brand, preferred brand specialty, non-preferred brand specialty) |
| Formulary 3 Preferred Drug List
The CareFirst Preferred Drug List represents a summary of Formulary 3 and is a guide to help you identify drugs that are both clinically appropriate and cost-effective. |
| Preventive Drug List
Preventive services help you stay healthy. This list indicates which drugs, health-related products or vaccines may be covered as preventive services at no cost to you. This means you may not have to pay a copay or coinsurance, even if you haven’t met your deductible. |
| Prescription Guidelines - Formulary 3
This is a list of drugs that may be covered through your prescription plan and is subject to utilization management such as prior authorization, quantity limits or step therapy. |
| Specialty Drug List
This is a list of specialty drugs that may be covered through either your prescription or medical plan. Specialty drugs are medications that may be used to treat rare health conditions and require special handling, administration or monitoring. |
| HealthyBlue Select Generics
This is a list of preventive drugs used to treat certain chronic conditions that are not subject to deductible and have a $0 copay for HealthyBlue CDH members. |
| Formulary 4 |
|---|
| Formulary 4, 2-Tier
(2-Tier: $0 drugs, generic drugs, brand drugs) |
| Preventive Drug List
Preventive services help you stay healthy. This list indicates which drugs, health-related products or vaccines may be covered as preventive services at no cost to you. This means you may not have to pay a copay or coinsurance, even if you haven’t met your deductible. |
| Specialty Drug List
This is a list of specialty drugs that may be covered through either your prescription or medical plan. Specialty drugs are medications that may be used to treat rare health conditions and require special handling, administration or monitoring. |
| Prescription Guidelines - Formulary 4
This is a list of drugs that may be covered through your prescription plan and is subject to utilization management such as prior authorization, quantity limits or step therapy. |
| Formulary 4 Quick Reference Guide |
| HealthyBlue Select Generics
This is a list of preventive drugs used to treat certain chronic conditions that are not subject to deductible and have a $0 copay for HealthyBlue CDH members. |
| Exchange Formulary
A formulary is a list of covered prescription drugs. |
| Abridged Exchange Formulary
The abridged formulary is an abbreviated version of the Exchange Formulary. |
| Exchange Preventive Drug List
Preventive services help you stay healthy. This list indicates which drugs, health-related products or vaccines may be covered as preventive services at no cost to you as part of the Affordable Care Act (ACA). This means you may not have to pay a copay or coinsurance, even if you haven’t met your deductible. |
| Prescription Guidelines - Exchange
This is a list of drugs that may be covered through your prescription plan and is subject to utilization management such as prior authorization, quantity limits or step therapy. |
| Specialty Drug List
This is a list of specialty drugs that may be covered through either your prescription or medical plan. Specialty drugs are medications that may be used to treat rare health conditions and require special handling, administration or monitoring.. |
| Exchange Formulary
A formulary is a list of covered prescription drugs. |
| Abridged Exchange Formulary
The abridged formulary is an abbreviated version of the Exchange Formulary. |
| Exchange Preventive Drug List
Preventive services help you stay healthy. This list indicates which drugs, health-related products or vaccines may be covered as preventive services at no cost to you as part of the Affordable Care Act (ACA). This means you may not have to pay a copay or coinsurance, even if you haven’t met your deductible. |
| Prescription Guidelines - Exchange
This is a list of drugs that may be covered through your prescription plan and is subject to utilization management such as prior authorization, quantity limits or step therapy. |
| Specialty Drug List
This is a list of specialty drugs that may be covered through either your prescription or medical plan. Specialty drugs are medications that may be used to treat rare health conditions and require special handling, administration or monitoring. |
| Drugs Requiring Prior Authorization - Formulary 2
This is a list of drugs that require a medical necessity prior authorization to be covered by your prescription drug plan. |
| Formulary 2, 3 Tier
(3-Tier: generic, preferred brand, non-preferred brand) |
| Formulary 2, 4 Tier
(4-Tier: generic, preferred brand, non-preferred brand, self injectables) |
| Formulary 2 Preferred Drug List
The CareFirst Preferred Drug List represents a summary of Formulary 2 and is a guide to help you identify drugs that are both clinically appropriate and cost-effective. |
| HealthyBlue Select Generics
This is a list of preventive drugs used to treat certain chronic conditions that are not subject to deductible and have a $0 copay for HealthyBlue CDH members. |
