2018 Plan Year

To request a hard copy of this directory, please call 1-866-249-8668 (TTY users call 711).
If a chain pharmacy does not provide a TTY number, TTY users you may call 711.

Our formulary covers both brand name drugs and generic drugs. A generic drug is approved by the FDA as having the same active-ingredient as the brand name drug. Generally, generic drugs cost less than brand name drugs. Members can contact our Plan for the most recent list of drugs at the number on the back of your Member ID card or locate the most recent list of drugs on our website.

You can get prescription drugs shipped to your home through our preferred mail order service and have the option to sign up for automated delivery. You should expect to receive your prescription drugs within 10 business days. If you do not receive your prescription drug(s) within this time, call 24/7: 1-888-648-9629; TTY 1-866-236-1069.

The Formulary may change at any time. You will receive notice when necessary. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Co-payments/co-insurance may change on January 1 of each year. Co-pays and co-insurance may vary based on the level of Extra Help you receive. Please contact the plan for further details.

If you have questions or would like additional plan information please call us at the number on the back of your Member ID card.

Si tiene preguntas o le gustaría información adicional sobre el plan por favor llamarnos al número que se encuentra en el respaldo de su tarjeta de identificación.