Prescription Drug Coverage
Take a closer look at our prescription drug coverage and pharmacy programs.
Information about the 2025 Weight Loss GLP-1 Formulary Changes
Beginning January 1, 2025, the tiers for some weight loss GLP-1 drugs will change for members with FEP Blue Standard™ and FEP Blue Basic™ plans. Review our FAQs to learn more about these changes, formulary exceptions and what to expect in 2025.
Pharmacy coverage you can count on
We want to make sure you and your family have convenient access to the prescription drugs you need.
The drug list includes all covered prescription drugs, including generic, brand name and specialty drugs for your plan.
You can fill your prescriptions at over 55,000 retail pharmacies, through the FEP Mail Service Program or the FEP Specialty Pharmacy Program.
2025 Drug Lists
FEP Blue Focus®
FEP Blue Basic™
FEP Blue Standard™
2024 Drug Lists
FEP Blue Focus®
Filling your prescriptions
Retail Pharmacy Program
Pick up your prescriptions conveniently at one of our more than 55,000 in-network pharmacies.
FEP Mail Service Pharmacy Program
If you’re a FEP Blue Standard member or FEP Blue Basic member with Medicare Part B primary, get your prescriptions delivered directly to your door.
FEP Specialty Pharmacy Program
Exclusively for members who are prescribed specialty drugs, this program helps you get them at a reasonable cost.
Get access to over 55,000 retail pharmacies nationwide
We have a network of over 55,000 Preferred retail pharmacies nationwide to fill your prescriptions. Use our pharmacy locator tool to find one near you.
Find a Pharmacy
Drug tiers
We organize our covered prescription drugs into Generics, Preferred Brand Name, Non-preferred Brand Name, Preferred Specialty and Non-preferred Specialty, which are known as tiers. The amount you pay for a drug depends on the tier. In general, the lower the drug tier, the less you pay.
Prescription drug benefits for 2025
See 2025 benefit updates and rates here.
| FEP Blue Focus® | FEP Blue Basic™ | FEP Blue Standard™ | |
|---|---|---|---|
| Preferred Retail Pharmacy |
Generics: $5 copay for up to a 30-day supply; $15 copay for a 31 to 90-day supply Preferred brand: 40% of our allowance ($350 max) for up to a 30-day supply; $1,050 maximum for 31 to 90-day supply |
Generics: $15 copay for up to a 30-day supply; $40 copay for a 31 to 90-day supply Preferred brand: $75 copay for up to a 30-day supply; $200 copay for a 31 to 90-day supply Non-preferred brand: 60% of our allowance ($90 minimum) for up to a 30-day supply; $250 minimum for a 31 to 90-day supply Preferred specialty: $120 copay Non-preferred specialty: $200 copay
Preferred specialty and Non-preferred specialty drugs are limited to a 30-day supply; only one fill allowed. All refills must be obtained from the Specialty Drug Pharmacy Program. |
Generics: $7.50 copay for up to a 30-day supply; $22.50 copay for a 31 to 90-day supply Preferred brand: 30% of our allowance Non-preferred brand: 50% of our allowance Preferred specialty: 30% of our allowance Non-preferred specialty: 30% of our allowance
Preferred specialty and Non-preferred specialty drugs are limited to a 30-day supply; only one fill allowed. All refills must be obtained from the Specialty Drug Pharmacy Program. |
| Mail Service Pharmacy | Not a benefit | Available to members with Medicare Part B primary only. Visit the Medicare page for more information. |
Generics: $15 copay Preferred brand: $90 copay Non-preferred brand: $125 copay Covers a 22 to 90-day supply. Nothing for the first 4 prescription fills or refills when you switch from certain brand name drugs to specific generic drugs. |
| Specialty Pharmacy |
Preferred specialty: 40% of our allowance ($350 maximum) Specialty drugs are limited to a 30-day supply. |
Preferred specialty: $120 copay for up to a 30-day supply; $350 copay for a 31 to 90-day supply Non-preferred specialty: $200 copay for up to a 30-day supply; $500 for a 31 to 90-day supply 90-day supply may only be obtained after third fill. |
Preferred specialty: $65 copay for up to a 30-day supply; $185 copay for a 31 to 90-day supply Non-preferred specialty: $85 copay for up to a 30-day supply; $240 copay for a 31 to 90-day supply |
Prescription drug benefits for 2024
See 2024 benefit updates and rates here.
| FEP Blue Focus® | FEP Blue Basic™ | FEP Blue Standard™ | |
|---|---|---|---|
| Preferred Retail Pharmacy |
Tier 1 (Generics): $5 copay up to a 30-day supply; $15 copay for a 31 to 90-day supply |
Tier 1 (Generics): $15 copay up to a 30-day supply; $40 copay for a 31 to 90-day supply Tier 2 (Preferred brand): $60 copay for up to a 30-day supply; $180 copay for a 31 to 90-day supply Tier 3 (Non-preferred brand): 60% of our allowance ($90 minimum) for up to a 30-day supply; $250 minimum for a 31 to 90-day supply) Tier 4 (Preferred specialty): $85 copay Tier 5 (Non-preferred specialty): $110 copay Tier 4 and 5 specialty drugs are limited to a 30-day supply; only one fill allowed. All refills must be obtained from the Specialty Drug Pharmacy Program. |
Tier 1 (Generics): $7.50 copay for up to a 30-day supply; $22.50 copay for a 31 to 90-day supply Tier 2 (Preferred brand): 30% of our allowance Tier 3 (Non-preferred brand): 50% of our allowance Tier 4 (Preferred specialty): 30% of our allowance Tier 5 (Non-preferred specialty): 30% of our allowance Tier 4 and 5 specialty drugs are limited to a 30-day supply; only one fill allowed. All refills must be obtained from the Specialty Drug Pharmacy Program. |
| Mail Service Pharmacy | Not a benefit | Available to members with Medicare Part B primary only. Visit the Medicare page for more information. |
Tier 1 (Generics): $15 copay Tier 2 (Preferred brand): $90 copay Tier 3 (Non-preferred brand): $125 copay Covers a 22 to 90-day supply. Nothing for the first 4 prescription fills or refills when you switch from certain brand name drugs to specific generic drugs. |
| Specialty Pharmacy |
Tier 2 (Preferred specialty): 40% of our allowance ($350 maximum) for a 30-day supply; $1,050 maximum for 31 to 90-day supply |
Tier 4 (Preferred specialty): $85 copay Tier 5 (Non-preferred specialty): $110 copay 90-day supply may only be obtained after third fill. |
Tier 4 (Preferred specialty): $65 copay for up to a 30-day supply; $185 copay for a 31 to 90-day supply Tier 5 (Non-preferred specialty): $85 copay for up to a 30-day supply; $240 copay for a 31 to 90-day supply 90-day supply may only be obtained after third fill. |
FEP Medicare Prescription Drug Program (MPDP)
Eligible members with Medicare get lower out-of-pocket costs for higher cost drugs and additional approved prescription drugs in some tiers than the traditional pharmacy benefit. New for 2025: the annual pharmacy out-of-pocket maximum is $2,000 per member and separate from the medical out-of-pocket maximum.
| FEP Blue Focus® with MPDP | FEP Blue Basic™ with MPDP | FEP Blue Standard™ with MPDP | |
|---|---|---|---|
| Retail Pharmacy^ |
Generics: $5 copay
Preferred brand: 40% of our allowance ($350 maximum)
Non-preferred brand: 40% of our allowance ($350 maximum)
Specialty: 40% of our allowance ($350 maximum) |
Generics: $10 copay Preferred brand: $45 copay Non-preferred brand: 50% of our allowance ($60 minimum) Specialty: $75 copay |
Generics: $5 copay Preferred brand: $35 copay Non-preferred brand: 50% of our allowance Specialty: $60 copay |
|
FEP Mail Service Pharmacy (What you'll pay for up to a 90-day supply of covered drugs) |
Not a benefit |
Generics: $15 copay Preferred brand: $95 copay Non-preferred brand: $125 copay Specialty: $150 copay |
Generics: $5 copay Preferred brand: $85 copay Non-preferred brand: $125 copay Specialty: $150 copay |
| FEP Specialty Pharmacy† | Your specialty drug benefits are in Tier 4 (see above) | Your specialty drug benefits are in Tier 4 (see above) | Your specialty drug benefits are in Tier 4 (see above) |
| FEP Blue Focus® with MPDP | FEP Blue Basic™ with MPDP | FEP Blue Standard™ with MPDP | |
|---|---|---|---|
| In-network Retail Pharmacy^ |
Tier 1 (Generics): $5 copay
Tier 2 (Preferred brand): 40% of our allowance ($350 max)
Tier 3 (Non-preferred brand): 40% of our allowance ($350 max)
Tier 4 (Specialty): 40% of our allowance ($350 max) |
Tier 1 (Generics): $10 copay Tier 2 (Preferred brand): $45 copay Tier 3 (Non-preferred brand): 50% of our allowance ($60 min) Tier 4 (Specialty): $75 copay |
Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): 15% of our allowance Tier 3 (Non-preferred brand): 50% of our allowance Tier 4 (Specialty): $60 copay |
|
FEP Mail Service Pharmacy (What you'll pay for up to a 90-day supply of covered drugs) |
Not a benefit |
Tier 1: $15 copay Tier 2: $95 copay Tier 3: $125 copay Tier 4: $150 copay |
Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): $85 copay Tier 3 (Non-preferred brand): $125 copay Tier 4 (Specialty): $150 copay |
| FEP Specialty Pharmacy† | Your specialty drug benefits are in Tier 4 (see above) | Your specialty drug benefits are in Tier 4 (see above) | Your specialty drug benefits are in Tier 4 (see above) |
| Annual Pharmacy Out-of- Pocket Maximum* | $3,250 per member | $3,250 per member | $2,000 per member |
^ What you'll pay for a 30-day supply of covered drugs. You can see what you'll pay for a 31- to 90-day supply of covered drugs in the benefits brochure.
† What you'll pay for up to a 30-day supply of covered drugs.
* You still have an overall medical out-of-pocket maximum. Your MPDP pharmacy out-of-pocket maximum is part of it, not added to it.
Helping you manage your prescriptions
We have programs that help you make the most of your prescription benefits and save money.
Specialty Pharmacy Program
Available to members with complex health conditions who need specialty drugs, including oral, inhaled, injected and infused drugs. This program also offers personalized support, convenient delivery, digital tools and more.
Patient-Centered Care (PCare) Program
Available to members at no cost, this comprehensive medication-therapy management program allows you to speak directly with a clinical pharmacist over the phone or via video chat to get help managing your medication therapy and lifestyle choices so you can reach your health goals.
Standard Option Generic Incentive Program
For FEP Blue Standard members who switch to a generic medication, we’ll waive your cost share for your first four prescription fills or refills.
View and download the Generic Incentive Program Drug List to see if there’s an alternative generic drug that can appropriately treat your condition.
Discount Drug Program
Discounts may vary, but members can save an average of 24% off some prescription drugs not covered by our pharmacy benefits.
View and download our Discount Drug Program Quick Reference Guide to learn more.
Have questions? Review our FAQs.
Your pharmacy coverage works outside the U.S., too*
Since there are no in-network retail pharmacies overseas, you need to pay for your prescriptions out-of-pocket and then submit your receipts and a completed claim form to get reimbursed. Overseas prescription drug claims must be submitted within one year of the purchase date.
Prior approval and covered equivalents
Have questions about our prescription drug coverage?
Retail Pharmacy Program
Mail Service Pharmacy
For refills, call: 1-877-FEP-FILL (1-877-337-3455)