Prescription Drug Lists (PDLs) for Exchange Plans: Small Business Health Options Program (SHOP)
Learn more about PDLs for health plans available through the Health Insurance Marketplace. The PDL includes brand and generic medications separated into cost levels called tiers. When selecting a medication, review the PDL to see if there is a Tier 1 option (lowest cost) to treat your condition. If your medication is in Tier 2, 3 or 4 (highest cost), you may pay more.
2023 PDLs
- 4 Tier Essential PDL with Specialty Medication Cost Share Drugs
Use for all plans except for those listed below
- 4 Tier Essential PDL without Specialty Medication Cost Share Drugs
Use for:- Optimum Choice, Inc
- UHC OCI Platinum 500
- UHC OCI Platinum 0-1
- UHC OCI Gold 500
- UHC OCI Silver 4850
- UHC OCI Silver 2100
- UHC OCI Bronze 7500
- UHC OCI HSA Bronze 7000
- UHC OCI HSA Bronze 6350
- UnitedHealthcare Insurance Company
- UHC Choice Platinum 500
- UHC Choice Plus Platinum 0-4
- UHC Choice Gold 500
- UHC Choice Plus Gold 500
- UHC Choice Plus Gold 0-1
- UHC Choice Plus Silver 4850
- UHC Choice HSA Bronze 7000
- UHC Choice Plus Bronze 7500
- UHC Choice Plus HSA Bronze 6350
- UnitedHealthcare of the Mid-Atlantic, Inc.
- UHC Core Essential Platinum 0-4
- UHC Core Essential Gold 500
- UHC Core Essential Silver 4850
- UHC Core Essential Bronze 7500
- UHC Core Essential HSA Bronze 7000
- UHC Core Essential HSA Bronze 6350
- UHC Navigate HSA Bronze 7000
- Optimum Choice, Inc
- 4 Tier Essential PDL with Specialty Medication Cost Share Drugs
Use for all plans except for those listed below
- 4 Tier Essential PDL without Specialty Medication Cost Share Drugs
Use for:- MAMSI Life and Health Insurance Company
- UHC Choice HSA Bronze 7000-2
- Optimum Choice, Inc.
- UHC OCI HSA Bronze 7000-2
- UnitedHealthcare Insurance Company
- UHC Choice Plus HSA Bronze 7000-2
- UnitedHealthcare of the Mid-Atlantic, Inc.
- UHC Navigate HSA Bronze 7000-2
- MAMSI Life and Health Insurance Company
2022 PDLs
- 4 Tier Essential PDL with Specialty Medication Cost Share Drugs
Use for all plans except for those listed below
- 4 Tier Essential PDL without Specialty Medication Cost Share Drugs
Use for:- Optimum Choice, Inc
- UHC OCI Platinum 500
- UHC OCI Gold 500
- UHC OCI Silver 5000-1
- UHC OCI Silver 2000
- UHC OCI HSA Bronze 7000
- UnitedHealthcare Insurance Company
- UHC Choice Platinum 500
- UHC Choice Plus Gold 0-1
- UHC Choice Gold 500
- UHC Choice HSA Bronze 7000
- UHC Core Essential HSA Bronze 7000
- UnitedHealthcare of the Mid-Atlantic, Inc.
- UHC Navigate HSA Bronze 7000
- Optimum Choice, Inc
- 4 Tier Essential PDL with Specialty Medication Cost Share Drugs
Use for all plans except for those listed below - 4 Tier Essential PDL without Specialty Medication Cost Share Drugs
Use for:- MAMSI Life and Health Insurance Company
- UHC Choice HSA Bronze 7000-2
- Optimum Choice, Inc.
- UHC OCI Silver 2000-2
- UHC OCI HSA Bronze 7000-2
- UnitedHealthcare Insurance Company
- UHC Choice Plus HSA Bronze 7000-2
- UnitedHealthcare of the Mid-Atlantic, Inc.
- UHC Core Essential HSA Bronze 7000-2
- UHC Navigate HSA Bronze 7000-2
- MAMSI Life and Health Insurance Company
- Visit www.uhceservices.com/nyshop to learn more
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
The Company does not discriminate on the basis of race, color, national origin, age, disability, or sex in its health programs or activities. To learn more, read the entire Non-Discrimination Notice.
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