Go to legend

Drug Name Search

By Therapeutic Class

BCSALBLDWN - Drug Lookup


We cover both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.

What is a Formulary?

A formulary is a list of covered drugs which represents the prescription therapies believed to be a necessary part of a quality treatment program. We will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy, and other plan rules are followed. For more information on how to fill your prescriptions, please review your Prescription Drug Plan Brochure.

Formulary Documents

    The following file requires Adobe Acrobat. Download Adobe Acrobat

  • Printable Formulary (PDF)
  • Preferred Drug List - Access (PDF)
  • Prior Authorization (PDF)
  • Quantity Limits (PDF)
  • Specialty Drug List (PDF)
  • Step Therapy (PDF)

  • How to Search for Drugs

  • Search by typing the first part of the generic (chemical) and brand (trade) names.
  • Search by selecting the therapeutic class of the medication you are looking for.
  • Products matching the search terms will display. Drugs that are on the List of Covered Drugs (Formulary) will display with tier status and limits and restrictions such as Prior Authorization, Quantity Limits, or Step Therapy requirements. Drugs that are not included on the List of Covered Drugs will display as “NF” (not on the formulary) or “EX” (excluded from formulary).

How to Request a Coverage Determination

You can ask us to make an exception to our coverage rules. There are several types of coverage determinations that you can ask us to make:

  • You can ask us to cover your drug when it requires a clinical review prior to authorization.

  • You can ask us to waive coverage restrictions or limits on your drug.

  • You can ask us to cover your drug when it is not covered on your formulary.

  • You can ask us to provide a higher level of coverage for your drug.

    You, your doctor, or your pharmacy may contact us to ask us for a coverage determination for a formulary, tiering or utilization restriction exception. When requesting a formulary, tiering or utilization restriction exception, your provider may be required to submit clinical documentation supporting the request. Generally, we must make our decision within 3 business days of getting your prescribing physician’s supporting clinical documentation. You can request an expedited (fast) exception if you or your doctor believe that your health could be seriously harmed by waiting up to 3 business days for a decision. If your request to expedite is granted, we must give you a decision no later than the end of the following business day after receipt of all required information. You may start a coverage determination by contacting MedOne Pharmacy Benefit Solutions at 1-888-884-6331.

    The formulary drug lookup tool is for informational use only and does not guarantee coverage, lack of coverage, or coverage requirements for any specific drug therapy. Information within the formulary drug lookup tool is subject to change. Additional plan limitations and requirements may apply. If you have questions regarding the medications covered under your prescription drug benefit, please call MedOne Pharmacy Benefit Solutions at 1-888-884-6331.
  • Legend

    • T0
      - Preventative
    • T1
      - Generics
    • T2
      - Preferred Brands
    • T3
      - Non-Preferred Brands
    • EX
      - Excluded
    • T4
      - Specialty
    • NF
      - Non-Formulary