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.

Individual and small employers - Affordable Care Act (ACA) policies

Purchased on or after Jan. 1, 2014

Prime 4-Tier Marketplace

(Copay plus, Classic & Value copay members)

2023

Formulary

ACA High Deductible Health Plan 4-tier

2023

Formulary

Individual and small employers pre-ACA transitional policies

Purchased before Jan. 1, 2014

Preventive drugs

Preventive drug list, effective 1/1/23
Expanded preventive drug list, effective upon your 2023 renewal date

Select 5-Tier

Formulary

High Deductible Health Plan 4-Tier

Formulary

Large employers

Preventive drugs

Preventive drug list, effective 1/1/23
Expanded preventive drug list, effective upon your 2023 renewal date

Select 3-tier

Formulary

Select 4-tier

Formulary

High Deductible Health Plan 4-tier

Formulary

Aon Active Health Exchange formulary

Preventive drugs

Preventive drug list, effective 1/1/23

Select 3-Tier formulary
Walgreens employee formulary

Prevea360 Medicare Advantage

Comprehensive formulary

See our formulary management process

Learn about diabetic pharmacy benefits