Drug formulary

Prevea360 drug formularies

Prevea360 has developed these drug formularies to help you and your providers with choosing the appropriate drugs based on your needs, coverage plan and cost of each drug.

Purchased on or after Jan. 1, 2014

Prime 4-Tier Marketplace 
(Copay plus, Classic & Value copay members)  
ACA High Deductible Health Plan 4-tier
Purchased before Jan. 1, 2014
View preventive drug list effective July 1, 2021.

Select 5-Tier
High Deductible Health Plan 4-Tier
View preventive drug list effective July 1, 2021.