I Want to See

Pharmacy Resources & Forms

Drug Lists

We strive to offer you many convenient and affordable ways for you to purchase your prescriptions and medications. Working with your doctor and pharmacist, you can use the appropriate prescription drug lists below to make smart choices about the drugs you take and the amount you pay.


Preferred Formulary

2016 Preferred Formulary Reference Guide

Limited Formulary

2016 Limited Formulary Reference Guide

Essential Formulary
(Marketplace, Individual and Small Group Commercial Plans)

2016 Essential Formulary Reference Guide


2016 CoverKids Formulary Reference Guide


Tools & Forms

Provider specific information to help manage plan member's health.


Provider Forms

Drug Authorization Forms

  • Pharmaceutical Exception Request Form
    Use this form for requesting an exception when a drug authorization form is not available.
  • Medication Review Request Fax Cover
    Use this fax cover sheet if your authorization request was denied and you are requesting an appeal, or if you are requesting review for coverage of an excluded pharmacy product. Please note: This form is a cover sheet only. You are required to submit pertinent medical information that supports the pharmacy related request along with this fax cover form.


Pharmacy Programs

How the Health Insurance Marketplace May Impact You

You already help your patients improve their health. Now you can help connect them to the Health Insurance Marketplace.

Find out more about the Marketplace