2023 Approved Drug List
Electronic prior authorization
Downloads
Some drugs may require your provider to complete an authorization form. Search our online formulary tools for and the information below to understand drug and plan specific coverage information, including prior authorization, step therapy requirements, quantity limits and age limits.- Commercial/Individual prior authorization criteria
- Pharmacy drug request
- Oral oncology drug request
- Opioid quantity limit exception request
Drugs covered under the medical benefit
- Medical Benefit Drug List (MBDL) (formerly the Injectable drug list)
- Medical drug request
- Oncology medical drug request
- Injectable drugs Site of Service policy and billing guidelines
Medical drug-specific forms are linked in the Medical Benefit Drug List
SaveOnSP
Select Specialty Medications for eligible members may be able to obtain copay assistance through SaveOn.
Additional Coverage
If you have an HSA plan, you may receive additional coverage through your employer for certain medications. This coverage is called a plan rider. Check your plan documents to see whether one of the below riders is included in your plan.