DRUG LIST AND
PHARMACY TOOLS

Our drug lists

A drug list, or formulary, is a list of prescription drugs that are covered under your pharmacy benefit plan. Each drug list is separated into tiers based on type and cost of medications. We base our therapeutic care decisions on:

  • Strong clinical foundation through our independent pharmacy and therapeutics (P&T) review process.
  • Access to drugs and therapies with clinical evidence to improve health, while trying to keep health care more affordable.
  • Total cost-of-care focus without sacrificing access to high-quality prescription drugs
  • View or download our latest drug list updates.
  • Keep up to date on the latest drug recalls and alerts.
  • Suggest a change or addition to our drug lists.

To find out more, visit our How We Evaluate Care Options page.

Essential Drug List

This list may be for you if your health insurance plan is through an employer. Check with your employer to make sure your plan includes the IngenioRx Essential Drug List. Or contact the Pharmacy Member Services number on your member ID card if you need assistance.

Essential 3 Tier  Searchable  |  PDF
Essential 4 Tier  Searchable  |  PDF
Essential 5 Tier  Searchable  |  PDF

 
 

National Drug List

This list may be for you if your health insurance plan is through an employer. Check with your employer to make sure your plan includes the IngenioRx National Drug List. Or contact the Pharmacy Member Services number on your member ID card if you need assistance.

National 3 Tier  Searchable  |  PDF
National 4 Tier  Searchable  |  PDF
National 5 Tier  Searchable  |  PDF

 
 

National Direct Drug List

This list may be for you if your health insurance plan is through an employer. Check with your employer to make sure your plan includes the IngenioRx National Direct Drug List. Or contact the Pharmacy Member Services number on your member ID card if you need assistance.

National Direct 3 Tier Searchable  |  PDF
National Direct 4 Tier Searchable  |  PDF
National Direct 5 Tier Searchable  |  PDF

 
 

Traditional Open Drug List

This list may be for you if your health insurance plan is through an employer. Check with your employer to make sure your plan includes the IngenioRx Traditional Open Drug List. Or contact the Pharmacy Member Services number on your member ID card if you need assistance.

Traditional Open 4 Tier Searchable  |  PDF
Traditional Open 5 Tier Searchable  |  PDF

 
 

Benefit/Program Drug Lists

One or more Benefit/Program Drug Lists may also apply to your plan. If your plan includes a benefit such as PreventiveRx or Exclusive Specialty, you will find your plan’s applicable drug lists here


PreventiveRx Drug Lists

One of these lists may apply to you if your plan includes the PreventiveRx benefit (members can receive certain preventive drugs at low or no cost). Check with your employer or contact the Pharmacy Member Services number on your member ID card if you need assistance.

If you have the Essential formulary/drug list, this PreventiveRx drug list may apply to you:

PreventiveRx Essential  PDF

If you have the National formulary/drug list, one of these PreventiveRx drug lists may apply to you:

PreventiveRx National  PDF

Exclusive Specialty Drug List

This list includes the specialty drugs that must be filled through a participating specialty pharmacy in order for coverage to be provided. This list only applies if you have a specialty pharmacy network included in your benefit.

Exclusive Specialty  PDF

Home Delivery Drug List

This list may be for you if you refill prescriptions through home delivery for maintenance drugs, which are used to treat long-term conditions like high blood pressure or diabetes.

Home Delivery  PDF

Find a participating pharmacy

If you are a member with IngenioRx pharmacy coverage, you can log in and search online or use these lists to find participating pharmacies in your network.
The Rx Choice Tiered, Standard and National Networks include Retail 90 and Rx Maintenance 90 pharmacies. These are pharmacies, including CVS, where you can fill up to a 90-day supply of your medicine. If your plan includes Rx Maintenance and you use CVS, you can fill a 90-day supply of any covered drug at your home delivery rate.
In the lists, Retail 90 pharmacies are designated with an asterisk (*) and Rx Maintenance 90 pharmacies are designated with a bullet (•).
 

Rx Choice Tiered Network (includes Retail 90 and Rx Maintenance 90)

With the Rx Choice Tiered Network, you can choose from two types of pharmacies:

Level 1 pharmacies: pay your copay as outlined by your benefit design.

Level 2 pharmacies: pay your copay as outlined PLUS an additional copay.

Rx Choice Tiered Network List  

National Pharmacy Network (includes Retail 90 and Rx Maintenance 90)

The National Network is our largest pharmacy network and includes nearly 70,000 retail pharmacies across the country.

National Pharmacy Network List PDF

Standard Network (includes Retail 90 and Rx Maintenance 90)

IngenioRx's managed pharmacy network, the Standard Network includes nearly 58,000 independent, regional and national retail pharmacies across the country.

Standard Pharmacy Network List PDF