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)

2023

Formulary
 

ACA High Deductible Health Plan 4-tier

2023

Formulary

Purchased before Jan. 1, 2014

Preventive drugs



Select 5-Tier
High Deductible Health Plan 4-Tier

Preventive drugs


Select 3-tier Select 4-tier High Deductible Health Plan 4-tier