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Preferred drug list
search tool and updates

Stay up-to-date with your medicine. A preferred drug list is a list of medicines we cover. We keep it up-to-date for you. And make it easy to manage your medicines and your loved ones’ medicines.

 

Find out if your medicine is covered

 

Search our preferred drug list

Our preferred drug list search tool

There are many different things that you can do with our preferred drug list search tool. You can:

 

  • Search for your medicine by name or class
  • Find generic alternatives to your medicine
  • See if your medicine has quantity limits, has age limits or requires prior authorization 

May 2025

 

Additions:

  • Tymlos Subcutaneous Solution Pen-Injector 3120 mcg /1.56 mL (Add Prior Authorization, Quantity Level Limit)
  • Prolia Injection Solution Prefilled Syringe 60 mg / mL (Add Prior Authorization, Quantity Level Limit)
  • Teriparatide Solution Pen-Injection 620 mcg/ 2.48 mL (Add Prior Authorization, Quantity Level Limit)

 

Removals:

  • No updates

 

Other Updates:

  • No updates

 

April 2025

 

Additions:

  • No updates

 

Removals:

  • No updates

 

Other Updates:

  • No updates

 

March 2025

 

Additions:

  • No updates

 

Removals:

  • No updates

 

Other Updates:

  • No updates

 

February 2025

 

Additions:

  • Estradiol Valerate Multi Dose Vial 20 mg/ mL (Quantity Level Limit)
  • Estradiol Valerate Multi Dose Vial 40 mg/ mL (Quantity Level Limit)
  • Sodium/Potassium Solution Magnesium (Quantity Level Limit)

 

Removals:

  • Testosterone (AndroGel) Pak 1%(50mg)
  • Testosterone (Fortesta) Gel Pump 2%
  • Testosterone Gel 1%(25mg)
  • Testosterone Gel Pump 1%

 

Other Updates:

  • Oxybutynin Tablet 10 mg Extended Release (Quantity Level Limit)

 

January 2025

 

Additions:

  • No updates

 

Removals:

  • No updates

 

Other Updates:

  • No updates

December 2024

 

Additions:

  • No updates

 

Removals:

  • No updates

 

Other Updates:

  • No updates

 

November 2024

 

Additions:
  • Ninguna

 

Removals:
  • None

 

Other Updates:
  • None

 

October 2024

 

Additions:
  • No updates

 

Removals:
  • No updates

 

Other Updates:
  • No updates

 

September 2024

 

Additions:
  • No updates

 

Removals:
  • No updates

 

Other Updates:
  • No updates

 

August 2024

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

July 2024

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

June 2024

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

May 2024

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

April 2024

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

March 2024

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

February 2024

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

January 2024

 

Additions:
  • No updates
Removals:
  • No updates
Other Updates:
  • No updates

December 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

November 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

October 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

September 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

August 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

July 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

June 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • Mavyret Pellet Pack 50-20 mg (Quantity Level Limit, Removed Prior Authorization)
  • Mavyret Tablet 100-40 mg (Quantity Level Limit, Removed Prior Authorization)
  • Sofosbuvir-Velpatasvir Tablet 400-100 mg (Quantity Level Limit, Removed Prior Authorization)

 

May 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

April 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • *Calcium Alginate Wound Dressing***
  • *Neomycin-Bacitracin-Polymyxin with Lidocaine Ointment 4%***
  • *Pediatric Multiple Vitamin with Minerals & C Chewable Tablet**
  • *Pediatric Multiple Vitamins with Iron Drops 10 mg/mL**
  • Cholecalciferol Drops 10 mcg/0.025 mL (400 Unit/0.025ml)
  • Cholecalciferol Drops 125 mcg/ mL (5000 Unit/mL)
  • Cholecalciferol Drops 400 Unit/0.028 mL (Per Drop)
  • Formaldehyde Solution 10%
  • Loperamide Hydrochloride Liquid 1 mg/5 mL (0.2 mg/mL)
  • Magnesium Salicylate Tablet 500 mg
  • Magnesium Tablet 400 mg
  • Phenylephrine-Shark Liver Oil-Mineral oil-Petrolatum Ointment 0.25-3-14-71.9%
  • Psyllium Capsule 400 mg
  • Psyllium Powder 30%
  • Psyllium Powder 30.9%
  • Psyllium Powder 33%
  • Psyllium Powder 49%
  • Uridine Triacetate Oral Granules Packet 10 gm

 

Other Updates:

 

  • Betamethasone Dipropionate Ointment 0.05% (Quantity Level Limit)
  • Fluocinolone Acetonide Cream 0.025% (Quantity Level Limit)
  • Fluocinolone Acetonide Ointment 0.025% (Quantity Level Limit)
  • Fluconazole Tablet 150 mg (Quantity Level Limit)
  • Freestyle 14 Sensor Libre (Quantity Level Limit)
  • Freestyle 14 Sensor Libre 2 (Quantity Level Limit)
  • Freestyle 14 Sensor Libre 3 (Quantity Level Limit)
  • *Pediatric Multiple Vitamins with Fluoride Chewable Tablet 0.25 mg***
  • *Pediatric Multiple Vitamins with Fluoride Chewable Tablet 0.5 mg***
  • *Pediatric Multiple Vitamins with Fluoride Chewable Tablet 1 mg***

 

March 2023

 

Additions:

 

  • Guaifenesin-Codeine Solution 100-6.33 mg/5 mL (Quantity Level Limit, Age Limit)

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

February 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

January 2023

 

Additions:

 

  • No updates

 

Removals:

 

  • Testosterone Td Gel 40.5 Mg/2.5 GM (1.62%)

 

Other Updates:

 

  • Testosterone Td Soln 30 Mg/Act (Prior Authorization Required)
  • Testosterone Td Gel 25 Mg/2.5gm (1%) (Prior Authorization Required)
  • Testosterone Td Gel 50 Mg/5gm (1%) (Prior Authorization Required)
  • Testosterone Td Gel 12.5 Mg/Act (1%) (Prior Authorization Required)
  • Testosterone Td Gel 20.25 Mg/Act (1.62%) (Prior Authorization Required)
  • Testosterone Td Gel 10mg/Act (2%) (Prior Authorization Required)
  • Testosterone Cypionate Im Inj In Oil 100 Mg/Ml (Prior Authorization Required)
  • Testosterone Cypionate Im Inj In Oil 200 Mg/Ml (Prior Authorization Required)
  • Testosterone Enanthate Im Inj In Oil 200 Mg/Ml (Prior Authorization Required)

December 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

November 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

October 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

September 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • Ceftriaxone Sodium For Inj 1 Gm (Changed Quantity Level Limit)
  • Ceftriaxone Sodium For Inj 2 Gm (Changed Quantity Level Limit)
  • Ceftriaxone Sodium For Inj 250 Mg (Changed Quantity Level Limit)
  • Ceftriaxone Sodium For Inj 500 Mg (Changed Quantity Level Limit)

 

August 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

July 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

June 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

May 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

April 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

March 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

February 2022

 

Additions:

 

  • Levocetirizine 5mg Tablets (Quantity Limit)
  • Dexcom G5 Mis Transmit (Quantity Limit)
  • Dexcom G6 Mis Transmit (Quantity Limit)
  • G5/G4 Plati Mis Sensor (Quantity Limit)
  • Dexcom G6 Mis Sensor (Quantity Limit)
  • Dexcom G5 Mis Receiver (Quantity Limit)
  • Dexcom G6 Mis Receiver (Quantity Limit)
  • Freestyle 10 Sen Libre (Quantity Limit)
  • Freestyle 10 Reader Libre (Quantity Limit)
  • Freestyle 14 Sen Libre (Quantity Limit)
  • Freestyle 14 Reader Libre (Quantity Limit)
  • Freestyle 14 Sen Libre 2 (Quantity Limit)
  • Freestyle 14 Reader Libre 2 (Quantity Limit)

 

Removals:

 

  • Diphenhydramine elixir

 

Other Updates:

 

  • Medroxyprogesterone Acetate 150mg/mL Syringe (Quantity Limit updated)
  • Diphenhydramine liquid (Quantity Limit updated)
  • Promethazine syrup (Quantity Limit updated)

 

January 2022

 

Additions:

 

  • No updates

 

Removals:

 

  • Nozin Nasal Kit Sanitize
  • Calcium 600 Tab +D

 

Other Updates:

 

  • No updates

 

December 2021

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

November 2021

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

October 2021

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

September 2021

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

August 2021

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

July 2021

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

June 2021

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

May 2021

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

April 2021

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

March 2021

 

Additions:

 

  • Hizentra Inj 1gm/5ml (Prior Authorization)
  • Hizentra Inj 2gm/10ml (Prior Authorization)
  • Hizentra Inj 2gm/10ml (Prior Authorization)
  • Hizentra Inj 4gm/20ml (Prior Authorization)
  • Hizentra Sol 20% (Prior Authorization)
  • Hizentra Via 10gm/50m (Prior Authorization)
  • Hizentra Via 1gm/5ml (Prior Authorization)
  • Immune Globulin (Human) Iv Or Subcutaneous Soln 1 Gm/10 (Prior Authorization)
  • Immune Globulin (Human) Iv Or Subcutaneous Soln 10 Gm/1 (Prior Authorization)
  • Immune Globulin (Human) Iv Or Subcutaneous Soln 20 Gm/2 (Prior Authorization)
  • Immune Globulin (Human) Iv Or Subcutaneous Soln 5 Gm/50 (Prior Authorization)
  • Privigen Inj 10grams (Prior Authorization)
  • Privigen Inj 40grams (Prior Authorization)
  • Privigen Inj 5 Grams (Prior Authorization)
  • Privigen Via 20grams (Prior Authorization)

 

Other Updates:

 

  • Arnuity Elpt Inh 100mcg (Quantity Limit Added)
  • Arnuity Elpt Inh 200mcg (Quantity Limit Added)
  • Arnuity Elpt Inh 50mcg (Quantity Limit Added)
  • Bevespi      Aer 9-4.8mcg (Quantity Limit Added)
  • Levofloxacin Sol 25mg/Ml (Quantity Limit, Age Limit Added)
  • Neomycin-Polymyxin-Dexamethasone Ophth Oint 0.1% (Quantity Limit Added)
  • Phenylephrine Hcl Ophth Soln 2.5% (Quantity Limit Added)
  • Rabeprazole  Tab 20 (Quantity Limit Added)

 

February 2021

 

Additions:

 

  • No updates

 

Removals:

 

  • No updates

 

Other Updates:

 

  • No updates

 

January 2021

 

Removals:

 

  • Ogestrel Tablet 0.5-50mg-mcg

 

Other Updates:

 

  • Antabuse 250mg, 500mg (Removed Quantity Level Limit)
  • Buprenorphine-Naloxone 2-0.5mg, 8-2mg sublingual tablet (Removed Quantity Level Limit)
  • Buprenorphine 2mg, 8mg sublingual tablet (Removed Quantity Level Limit)
  • Naloxone 0.4mg/mL injection solution (Removed Quantity Level Limit)
  • Naloxone 0.4mg/mL injection syringe (Removed Quantity Level Limit)
  • Naloxone 1mg/mL injection syringe (Removed Quantity Level Limit)
  • Narcan 4mg/actuation nasal spray (Removed Quantity Level Limit)
  • Probuphine 74.2mg subdermal implant (Removed Quantity Level Limit)
  • Sublocade 100mg/0.5ml, 300mg/1.5ml solution, extended release subcutaneous syringe (Removed Quantity Level Limit)

Have questions?

Call Member Services at
1-866-329-4701 (TTY: 711).

Call Member Services at
1-866-329-4701 (TTY: 711).

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