Prescription Drug Lists (PDLs) for UnitedHealthcare Individual & Family ACA Marketplace plans
Effective January 1, 2023
Learn more about PDLs for health plans available through the Health Insurance Marketplace. The PDL includes brand and generic medications. You’ll find medications separated into cost levels called tiers. If you can, select a Tier 1 medication option (lowest cost) to treat your condition. If your medication is in Tier 2, 3, 4 or 5 (highest cost), you may pay more.
Your plan only covers medications listed on the PDL. Sometimes you may need access to medications that require a prior authorization, or you may need a medication not listed on the PDL (these are drugs that are listed as Non-Formulary). You or your healthcare provider can request a prior authorization or exception for us to cover the medication.
Learn more about your birth control (contraceptive) coverage.
- If your plan name includes “Standard,” use the AL QHP Standard drug list
- For all other plans use the AL Essental Plus drug list
- If your plan name includes “Standard,” use the AZ QHP Standard drug list
- For all other plans use the AZ Essential Plus drug list
- If your plan name includes “Options,” use the CO Options drug list
- For all other plans use the CO Essential Plus drug list
- Gender-Affirming Care Coverage Guide – Hormone Therapy Effective 1/1/24
- If your plan name includes “Standard,” use the FL QHP Standard drug list
- For all other plans use theFL Essential Plus drug list
- If your plan name includes “Standard,” use the GA QHP Standard drug list
- For all other plans use the GA Essential Plus drug list
- If your plan name includes “Standard,” use the IL QHP Standard drug list
- For all other plans use the IL Essential Plus drug list
- If your plan name includes “Standard,” use the KS QHP Standard drug list
- For all other plans use the KS Essential Plus drug list
- If your plan name includes “Standard,” use the LA QHP Standard drug list
- For all other plans use the LA Essential Plus drug list
All Massachusetts plans use the Advantage drug list.
All Maryland plans use the MD Essential Plus drug list.
- If your plan name includes “Standard,” use the MI QHP Standard drug list
- For all other plans use the MI Essential Plus drug list
- If your plan name includes “Standard,” use the MS QHP Standard drug list
- For all other plans use the MS Essential Plus drug list
- If your plan name includes “Standard,” use the MO QHP Standard drug list
- For all other plans use the MO Essential Plus drug list
All Nevada plans use the Sierra Individual formulary drug list.
All New York plans use the Advantage drug list.
- If your plan name includes “Standard,” use the NC QHP Standard drug list
- For all other plans use the NC Essential Plus drug list
- If your plan name includes “Standard,” use the OH QHP Standard drug list
- For all other plans use the OH Essential Plus drug list
- If your plan name includes “Standard,” use the OK QHP Standard drug list
- For all other plans use the OK Essential Plus drug list
- If your plan name includes “Standard,” use the TN QHP Standard drug list
- For all other plans use the TN Essential Plus drug list
If your plan name includes “Standard,” use the QHP Standard drug list. There are 4 Standard plans with an exception:
- UHC Gold Standard $0 Deductible ($3 T1 Preferred Rx) – use Essential Plus drug list
- UHC Gold-A Standard $0 Deductible ($0 T1 Preferred Rx) – use Essential Plus drug list
- UHC Gold-B Standard $0 Deductible ($3 T1 Preferred Rx) – use Essential Plus drug list
- UHC Gold-X Standard $0 Deductible ($3 T1 Preferred Rx) – use Essential Plus drug list
All other plans use the Essential Plus drug list.
- If your plan name includes “Standard,” use the VA QHP Standard drug list
- For all other plans use the VA Essential Plus drug list
All Washington plans use the WA Essential Plus 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
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