Prescription Drug Online Tools and Resources
Search for a Drug in Your Current Plan
If you are an existing member, you should log in to My Account and select Drug and Pharmacy Resources under Coverage to find a pharmacy, refill prescriptions, see which formulary you are on or use the drug pricing tool. You can also call the pharmacy telephone number on your member ID card if you have additional questions.
Formulary
A formulary, also called a drug list, is a list of prescription drugs your insurance plan covers. It typically includes the most commonly prescribed drugs—both brand name and generic—and shows how much you pay for each drug. The purpose of a formulary is to help you contain costs and ensure quality of care.
Please note, 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.
Select Year:
2024 Plan Year
| Formulary 3 |
|---|
| Formulary 3, 5-Tier
(5-Tier: generic, preferred brand, non-preferred brand, preferred brand specialty, non-preferred brand specialty). |
| 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. |
| Formulary 3 Prescription Guidelines
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. |
| Formulary 3 Choice |
|---|
| Formulary 3 Choice
(5-Tier: generic, preferred brand, non-preferred brand, preferred brand specialty, non-preferred brand specialty). |
| Formulary 3 Choice Preferred Drug List
The CareFirst Preferred Drug List represents a summary of Formulary 3 Choice and is a guide to help you identify drugs that are both clinically appropriate and cost-effective. |
| Formulary 2 |
|---|
| Formulary 2, 3-Tier
(3-Tier: generic, preferred brand, non-preferred brand). |
| Formulary 2, 4-Tier
(4-Tier: generic, preferred brand, non-preferred brand, self injectables). |
| Formulary 2, 5-Tier
(5-Tier: generic, preferred brand, non-preferred brand, preferred brand specialty, non-preferred brand specialty). |
| Formulary 2 Preferred Drug List
The CareFirst Preferred Drug List represents a summary of Formulary 2 and is a guide to help you identify drugs that are both clinically appropriate and cost-effective. |
| Formulary 2 Prescription Guidelines
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. |
| Formulary 1 |
|---|
| Formulary 1, 3-Tier
(3-Tier: generic, preferred brand, non-preferred brand). |
| Formulary 1, 4-Tier
(4-Tier: generic, preferred brand, non-preferred brand, self-injectables). |
| Formulary 1, 5-Tier
(5-Tier: generic, preferred brand, non-preferred brand, preferred brand specialty, non-preferred brand specialty). |
| Formulary 1 Preferred Drug List
The CareFirst Preferred Drug List represents a summary of Formulary 1 and is a guide to help you identify drugs that are both clinically appropriate and cost-effective. |
| Formulary 1 Prescription Guidelines
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. |
| Additional Drug List Documents |
|---|
| $0 Select Generics
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. |
| Maintenance Drug List
This is a list of drugs that are considered maintenance and may be covered for up to a three-monthly supply. Maintenance drugs are commonly used to treat chronic or long-term conditions such as diabetes and asthma. |
| 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. |
| Rx Fundamentals
This is a list of preventive drugs where you may be able to pay your copay or coinsurance for your medication without having to meet your deductible. The enhanced list includes drugs for coronary artery disease, diabetes, hypertension, respiratory disorders, mental health and preventive services. |
| 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. |
2023 Plan Year
| Formulary 3 |
|---|
| Formulary 3, 5-Tier
(5-Tier: generic, preferred brand, non-preferred brand, preferred brand specialty, non-preferred brand specialty). |
| 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. |
| Formulary 3 Prescription Guidelines
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. |
| Formulary 2 |
|---|
| Formulary 2, 3-Tier
(3-Tier: generic, preferred brand, non-preferred brand). |
| Formulary 2, 4-Tier
(4-Tier: generic, preferred brand, non-preferred brand, self injectables). |
| Formulary 2, 5-Tier
(5-Tier: generic, preferred brand, non-preferred brand, preferred brand specialty, non-preferred brand specialty). |
| Formulary 2 Preferred Drug List
The CareFirst Preferred Drug List represents a summary of Formulary 2 and is a guide to help you identify drugs that are both clinically appropriate and cost-effective. |
| Formulary 2 Prescription Guidelines
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. |
| Formulary 1 |
|---|
| Formulary 1, 3-Tier
(3-Tier: generic, preferred brand, non-preferred brand). |
| Formulary 1, 4-Tier
(4-Tier: generic, preferred brand, non-preferred brand, self-injectables). |
| Formulary 1, 5-Tier
(5-Tier: generic, preferred brand, non-preferred brand, preferred brand specialty, non-preferred brand specialty). |
| Formulary 1 Preferred Drug List
The CareFirst Preferred Drug List represents a summary of Formulary 1 and is a guide to help you identify drugs that are both clinically appropriate and cost-effective. |
| Formulary 1 Prescription Guidelines
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. |
| Additional Drug List Documents |
|---|
| $0 Select Generics
This is a list of preventive drugs used to treat certain chronic conditions that are available at no cost (including no deductible) for members in fully-integrated Rx plans. This list is effective for HealthyBlue plans prior to August 1, 2023. It will apply to all fully-integrated plans on and after August 1, 2023. |
| Maintenance Drug List
This is a list of drugs that are considered maintenance and may be covered for up to a three-monthly supply. Maintenance drugs are commonly used to treat chronic or long-term conditions such as diabetes and asthma. |
| 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. |
| Rx Fundamentals
This is a list of preventive drugs where you may be able to pay your copay or coinsurance for your medication without having to meet your deductible. The enhanced list includes drugs for coronary artery disease, diabetes, hypertension, respiratory disorders, mental health and preventive services. |
| 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. |
Access Drug Tools and Resources
Use these tools to find a pharmacy, access drug forms, and learn more about your medications:
Find a Pharmacy
See if your local pharmacy is in the CareFirst network or use this tool to find a network pharmacy near you.
Drug Forms
Find the forms you need to submit a claim, set up mail order for your prescriptions and more.
Prescription Guidelines
Learn more about Prescription Guidelines that might affect how your drugs are covered.