What's Covered
Our drug lists make it easy to find out if a medicine is covered under your plan. A drug list, or formulary, is a list of prescription drugs that are covered under your pharmacy benefits. Each drug list is separated into tiers based on type and cost of medications. Lower-cost drugs and generics are usually in Tiers 1 and 2. You’ll save the most money when you use Tier 1 medication.
through our independent pharmacy and therapeutics (P&T) review process.
with clinical evidence to improve health, while trying to keep health care more affordable.
without sacrificing access to high-quality prescription drugs.
- View or download our latest drug list (formulary) updates.
- Keep up to date on the latest drug recalls and alerts.
- Suggest a change or addition to our drug lists.
- Read more about how we evaluate care options.
- Learn about ACA Preventive Drug List.
- Learn about ACA contraceptive services.
Focused 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 Focused Drug List. Or contact the Pharmacy Member Services number on your ID card if you need assistance.
Focused Drug List Medication Alternatives, Effective 1/1/2023
• Focused 3 Tier Searchable | PDF
• Focused 4 Tier Searchable | PDF
• Focused 5 Tier Searchable | PDF
Advanced 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 Advanced Drug List. Or contact the Pharmacy Member Services number on your ID card if you need assistance.
Advanced Drug List Medication Alternatives, Effective 1/1/2023
• Advanced 3 Tier Searchable | PDF
• Advanced 4 Tier Searchable | PDF
• Advanced 5 Tier Searchable | PDF
Guided 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 Guided Drug List. Or contact the Pharmacy Member Services number on your ID card if you need assistance.
Guided Drug List Medication Alternatives, Effective 1/1/2023
• Guided 3 Tier Searchable | PDF
• Guided 4 Tier Searchable | PDF
• Guided 5 Tier Searchable | PDF
Complete 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 Complete Drug List. Or contact the Pharmacy Member Services number on your member ID card if you need assistance.
• Complete 3 Tier Searchable | PDF
• Complete 4 Tier Searchable | PDF
• Complete 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 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.
Enhanced
- PreventiveRx Focused - PDF
- PreventiveRx Advanced - PDF
- PreventiveRx Complete - PDF
- PreventiveRx Guided - PDF
PreventiveRx Plus
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
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 Advantage, Performance, and Base 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 (•).
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.
The Base Network is our largest pharmacy network and includes nearly 70,000 retail pharmacies across the country.
- Base Pharmacy Network List - PDF
IngenioRx's high performance pharmacy network, the Advantage Network, includes nearly 58,000 independent, regional, and national retail pharmacies across the country.
- Advantage Pharmacy Network List - PDF