Prescription Drug Lists (PDLs) for UnitedHealthcare Individual & Family ACA Marketplace plans
Effective January 1, 2024
A Prescription Drug List (PDL) or a formulary is a list of covered prescribed 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 requirements 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 to treat your condition.
If your medication is not covered or has a coverage requirement 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 treat your condition.
When to use the Medication Search or PDF formats of the Prescription Drug list:
- For up-to-date coverage information, search for medications using the Medication Search.
- Use the PDF to learn about the drug list, tier information, and coverage requirements or limits such as prior authorization, step therapy, and quantity limits. The PDF also explains how to request a prior authorization or exception.
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.
Zero Cost-Share Medications
Opioid management
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 your Prescription Drug List
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 your Prescription Drug List
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 - 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
Updates to your Prescription Drug List
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 your Prescription Drug List
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 your Prescription Drug List
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 your Prescription Drug List
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 your Prescription Drug List
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 your Prescription Drug List
2024 Plan year
- All Massachusetts plans use the Advantage drug list.
2024 Plan year
- All plans use the Maryland 2024 Essential Plus Prescription Drug List (6-Tier):
Medication Search | English
Updates to your Prescription Drug List
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 your 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.
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 your Prescription Drug List
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 - Missouri one co-payment for dosage prescribed
English
Updates to your Prescription Drug List
2024 Plan year
- Visit healthplanofnevada.com or sierrahealthandlife.com for plan specific prescription drug lists.
2024 Plan year
- All plans use the New Jersey 2024 Essential Plus Prescription Drug List (5-Tier):
Medication Search | English
Updates to your Prescription Drug List
2024 Plan year
- All New York plans use the Advantage drug list.
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 your Prescription Drug List
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 your Prescription Drug List
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 your Prescription Drug List
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 your Prescription Drug List
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 your Prescription Drug List
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 your Prescription Drug List
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 your Prescription Drug List
2024 Plan year
- All plans use the Washington 2024 Essential Plus Prescription Drug List (4-Tier):
Medication Search | English | Spanish
Updates to your Prescription Drug List
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 your Prescription Drug List
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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