Information about Our Rates
Learn more about our premium rates here.
Our Prescription Drug Formularies
Use the prescription drug formularies below to see what is covered by your plan.
2020 Formularies
2020 High Performance Plus – Check this formulary if you are shopping for an on- or off exchange metal-tier plan (also called platinum, gold, silver or bronze plans).
2020 Basic Plus – Check this formulary if you are keeping your grandfathered plan or are part of a large employer-sponsored group plan.
Monthly Formulary Changes
2021 Formularies
2021 High Performance Plus – Check this formulary if you are shopping for an on- or off exchange metal-tier plan (also called platinum, gold, silver or bronze plans).
2021 Basic Plus – Check this formulary if you are keeping your grandfathered plan or are part of a large employer-sponsored group plan.
Transparency Information
Learn more about transparency in qualified health coverage here.
Information about Prior Approval
Certain services and drugs require prior approval before you have the procedure or service—especially if the service or drug is considered experimental or investigational and not eligible for coverage. Prior approval is not a guarantee of payment; payment is based on your benefits and contract provisions.
Learn more about our prior approval requirements here.
MCG Guidelines
MCG Guidelines are used to make coverage decisions for medical and mental health or substance use disorder benefits. View the guidelines here.