Formulary Information

The Formulary and Pharmacy network may change at any time. You will receive notice when necessary.
The directory is for a geographic area. We also list pharmacies that are in our network but are outside a geographic area.

The Formulary Lookup tools below will allow you to enter your prescriptions to determine which tier they will be covered under. Select

Effective 11/1/2021, we have some changes to the Exemplar Basic Formulary notated in the following Formulary Addendum:

Effective 11/1/2021, we have some changes to the Exemplar Enhanced Formulary notated in the following Formulary Addendum: