Prescription Drug Lists (PDLs) for UnitedHealthcare Individual & Family ACA Marketplace plans
Effective January 1, 2024 & January 1, 2025
A Prescription Drug List (PDL) or a formulary is a list of covered prescription medications or supplies. The PDL includes information you need, like:
- If your medication is covered
- What tier your medication is considered under your plan
- If your medication has coverage rules or limits, like prior authorization, step therapy or quantity limits
Choose a medication in Tier 1 or Tier 2 for your lowest cost options. If your medication is in a higher tier, you may pay more. Ask your health care provider if a lower cost medication can work for your condition.
If your medication is not covered or has a coverage rule or limit, talk to your health care provider. They may be able to ask about a prior authorization or exception to get your medication covered or may switch you to a covered medication that can work for your condition.
When to use the Medication Search or PDF formats of the Prescription Drug list:
- Use the Medication Search for up-to-date coverage information. You can learn what tier your medication is on and which coverage rules or limits apply. We may also give you helpful tips about your medications that are not available in the PDF.
- Use the PDF format to learn about definitions or general information. It also includes a list of medications that are covered, but the Medication Search is a better tool to give you this information.
Managing your pharmacy benefits
If you're a member with an Individual & Family Marketplace ACA plan, explore these tips for using and managing your pharmacy benefits.
Your UnitedHealthcare Individual & Family plan covers certain medications at no cost to you when filled at a network pharmacy.
2025 Plan year
2024 Plan year
Applies to all states except MA, NV, and NY.
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English | Spanish - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English | Spanish - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English | Spanish - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English | Spanish - Updates to the Prescription Drug List
- Gender-Affirming Care Coverage Guide - Hormone Therapy Effective 1/1/25
English | Spanish - Get to know diabetes - Your pharmacy benefits
- English: Colorado Option plans | HSA plans | All other plans
- Spanish: Colorado Option plans | HSA plans | All other plans
2024 Plan year
- If your plan name includes “Options,” use the Coloardo Options Prescription Drug List (5-tier):
Medication Search | English | Spanish - For all other plans, use the Colorado Essential Plus Prescription Drug List (6-tier):
Medication Search | English | Spanish - Updates to the Prescription Drug List
- Gender-Affirming Care Coverage Guide - Hormone Therapy Effective 1/1/24
English | Spanish - 2024 Colorado $0 Diabetic Supplies (for Colorado Options Plans only)
English | Spanish
2025 Plan year
- Prescription Drug List
Medication Search | English | Spanish - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English | Spanish - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English | Spanish - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Get to know diabetes - Your pharmacy benefits
- English | Spanish
2025 Plan year
- Prescription Drug List
Medication Search | English - Get to know diabetes - Your pharmacy benefits
- English | Spanish
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- All plans use the Maryland 2024 Essential Plus Prescription Drug List (6-Tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
Opioid management
To direct your healthcare provider to not administer an opioid or not offer a prescription for an opioid, you may fill out this form from the Michigan Department of Health and Human Services.
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
- Missouri one co-payment for dosage prescribed
English
2025 Plan year
- Prescription Drug List
Medication Search | English - Get to know diabetes - Your pharmacy benefits
English | Spanish
2025 Plan year
- Visit healthplanofnevada.com or sierrahealthandlife.com for plan specific prescription drug lists.
2024 Plan year
- Visit healthplanofnevada.com or sierrahealthandlife.com for plan specific prescription drug lists.
2025 Plan year
2024 Plan year
- All plans use the New Mexico 2024 Essential Plus Prescription Drug List (6-Tier):
Medication Search | English | Spanish - Updates to the Prescription Drug List
- New Mexico 2024 $0 Behavioral Health Coverage
English | Spanish
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- All plans use the New Jersey 2024 Essential Plus Prescription Drug List (5-Tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English | Spanish - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English | Spanish - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English | Spanish - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English | Spanish - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name does NOT include "Standard", use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English | Spanish - If your plan name is one of the following, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English | Spanish- UHC Gold Standard $0 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, $0 Insulin)
- UHC Gold-A Standard ($0 Virtual Urgent Care + $0 PCP Visits, $0 Tier 2 Rx, $0 Insulin)
- UHC Gold-B Standard $0 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, $0 Insulin)
- UHC Gold-X Standard $0 Indiv Ded ($0 Virtual Urgent Care + $0 PCP Visits, $3 Tier 2 Rx, $0 Insulin)
- For all other plans that include “Standard” in the plan name, use the QHP Standard Prescription Drug List (5-tier):
Medication Search | English | Spanish - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English | Spanish - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier):
Medication Search | English | Spanish - For all other plans, use the Essential Plus Prescription Drug List (6-tier):
Medication Search | English | Spanish - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English | Spanish - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- All plans use the Washington 2024 Essential Plus Prescription Drug List (5-Tier):
Medication Search | English | Spanish - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Updates to the Prescription Drug List
- Get to know diabetes - Your pharmacy benefits
English | Spanish
2024 Plan year
- If your plan name includes “Standard,” use the QHP Prescription Drug List (5-tier)
Medication Search | English - For all other plans, use the Essential Plus Prescription Drug List (6-tier)
Medication Search | English - Updates to the Prescription Drug List
2025 Plan year
- Prescription Drug List
Medication Search | English - Get to know diabetes - Your pharmacy benefits
- English | Spanish
Opioid management
Applies to all states except MA, NV, and NY.
Need help in another language?
- Visit language assistance resources for help in different languages.
- Para servicio al cliente en español, por favor llame al 1-800-985-3859, TTY 711, o visite la página de asistencia de recursos de idiomas
- 語言協助 / 不歧視通知
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