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2014 Affordable Care Act (ACA) Drug Lists

Due to the Affordable Care Act (ACA), also known as Health Care Reform, our Drug Lists for the new ACA plans will
change – effective January 1, 2014.

The 2014 Drug Lists below provide important information to you on what drugs are covered within ACA plans, do they require pre-authorization, quantity limits and much more.

Please note all ACA plans have Mandatory Generic Substitution which means if your provider prescribes a Non-preferred Brand drug and you get a Non-preferred Brand drug when a Generic is available, you will pay the Non-preferred Brand copay or coinsurance PLUS the difference between the Generic and Non-preferred Brand drug cost up to the cost of the prescription.

If you are an existing member, please refer to the Non-ACA Drug List.

ACA Consumer Direct Plans – DC & VA Markets

I am considering purchasing a 2014 health care plan directly through an insurance company (not through an employer) and I live in Washington DC or Virginia.

View Drug List

ACA Consumer Direct Plans – MD Market

I am considering purchasing a 2014 health care plan directly through an insurance company (not through an employer) and I live in Maryland.

View Drug List

ACA Small Group Plans – DC & VA Markets

I am receiving health insurance through my small employer (up to 50 employees) and my employer is headquartered in Washington DC or Virginia.

View Drug List

ACA Small Group Plans – MD Market

I am receiving health insurance through my small employer (up to 50 employees) and my employer is headquartered in Maryland.

View Drug List