Drug Search


To find out which formulary you are on, log on to My Account, click the Coverage tab and select Coverage Details. If you do not see your formulary listed below, check your summary of benefits or visit our Group site. See the chart at the bottom of this page for document descriptions.

Formulary

A formulary is a list of drugs covered under your plan. Please note that the formularies listed below are not all-inclusive lists and are subject to change. To search for a specific drug, open the PDF and click “CTRL” and “F” at the same time.

2020 PLAN YEAR

The following chart contains all of the most up-to-date drug lists along with helpful descriptions of each. The drug lists below may not be all inclusive, do not guarantee coverage and are subject to change.

Document
DocumentDescription
Abridged Exchange Formulary The abridged formulary is an abbreviated version of the Exchange Formulary.
Drugs Requiring Prior Authorization Formulary 2 This is a list of drugs that require a medical necessity prior authorization to be covered by your prescription drug plan.
Exchange Formulary A formulary is a list of covered prescription drugs.
Exchange Preventive Drug List Preventive services help you stay healthy. This list indicates which drugs, health-related products or vaccines may be covered as preventive services at no cost to you as part of the Affordable Care Act (ACA). This means you may not have to pay a copay or coinsurance, even if you haven’t met your deductible.
Formulary 3 A formulary is a list of covered prescription drugs.
Formulary 3 Preferred Drug List The CareFirst Preferred Drug List represents a summary of Formulary 3 and is a guide to help you identify drugs that are both clinically appropriate and cost-effective.
HealthyBlue Select Generics (CDH plans only) This is a list of preventive drugs used to treat certain chronic conditions that are not subject to deductible and have a $0 copay for HealthyBlue CDH members.
Preventive Drug List Preventive services help you stay healthy. This list indicates which drugs, health-related products or vaccines may be covered as preventive services at no cost to you. This means you may not have to pay a copay or coinsurance, even if you haven’t met your deductible.
Prescription Guidelines – Exchange This is a list of drugs that may be covered through your prescription plan and is subject to utilization management such as prior authorization, quantity limits or step therapy.
Prescription Guidelines – Formulary 3 This is a list of drugs that may be covered through your prescription plan and is subject to utilization management such as prior authorization, quantity limits or step therapy.
Specialty Drug List This is a list of specialty drugs that may be covered through either your prescription or medical plan. Specialty drugs are medications that may be used to treat rare health conditions and require special handling, administration or monitoring.

Lists for Grandfathered Plans

2020 Lists

Your plan year begins at renewal. If you buy direct, your plan year is January 1st of each year. If you buy your insurance through an employer, your plan year renewal month may vary. For example, if your employer benefits renew on April 1, 2020, you would refer to the 2019 Plan Year Formulary through March 2020 and refer to the 2020 Plan Year Formulary beginning April 2020.

woman on laptop

Buying Direct

If you buy your own insurance directly through CareFirst

Exchange Formulary

Abridged Exchange Formulary

two people meeting

2-50 Employees

If you buy insurance through your employer and there are less than 50 people in your company

Exchange Formulary

Abridged Exchange Formulary

meeting group

51+ Employees

If you buy insurance through your employer with more than 51 people in your company



F0

Formulary 3 Preferred
Drug List