Custom Drug List
Refer to the Custom Drug List (PDF) when prescribing medications for members with three-tier or closed (managed) drug list plans. Under the closed (managed) drug list benefit design, drugs listed as tier three (non-preferred brand) are not covered unless we authorize them as medically necessary.
You can also use the Custom Drug List Quick Guide (PDF) to find the medications within the most commonly prescribed therapeutic classes.
Certain drugs on the list may also require prior authorization or step therapy.
Drug list updates
The custom drug list is updated twice a year. Since a drug's status may change and new drugs may be added, we also publish a list of updates to keep you informed of those changes.
For the most recent drug list updates, including the custom drug list, read our Drug List Updates (PDF).
Drug list exclusions
Questions? We can help!
To verify a member's benefit plan or get answers to your pharmacy-related questions, please contact us.