Formulary Drug Lists

Get information about our pharmacy benefits, how prescription drugs may be covered, and recent drug list changes.

2026 Covered formulary drug lists

Different plans have different lists of covered drugs. Drug list codes can be found on member ID cards.

Individual

Group

Drug approval and benefit levels

Drugs requiring approval

Our pharmacy prior authorization program includes four types of reviews: Formulary exception, quantity limit, step therapy, and pre-approval. To learn about these reviews and to get request forms.

Visit our drugs requiring approval page

Drug benefit levels

LifeWise plans determine member costs by putting drugs into four tiers. Member ID card will show copay or coinsurance for each drug tier.

Learn more about drug benefit levels

Drug list changes

Effective July 1, 2026

(Individual and Group)

Formulary drug list - B3, B4, M1/M2, M4

Effective April 1, 2026

(Individual and Group)

Formulary drug list - B3, B4, M1/M2, M4

Effective January 1, 2026

(Individual and Group)

Formulary drug list - B3, B4, M1/M2, M4

*These drugs have been selected by an independent group of experts made up of doctors and pharmacists. This group reviews drugs to see how well they work relative to their cost. They also compare their effectiveness to similar drugs used to treat the same condition. Please talk with your doctor to see if these new options are right for you.