Prescription Drug Lists (PDLs) for Exchange Plans: Small Business Health Options Program (SHOP)
Sign into your member account or call the number on your health plan ID card to see your PDL and get specific information about your pharmacy benefits. If not a member, use the links below to 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.
2025 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 (OCI) HMO Plans
- Standard UHC OCI Platinum 0-1
- UHC OCI Gold 750-1
- Standard UHC OCI Gold 500
- Standard UHC OCI Silver 4850
- Standard UHC OCI Bronze 7500
- UHC OCI HSA Bronze 7100
- UHC OCI HSA Bronze 6350
- Standard UHC OCI Platinum 0-1
- Choice Plus Plans
- Standard UHC Choice Plus Platinum 0-4
- UHC Choice Plus Gold 750-1
- Standard UHC Choice Plus Gold 500
- Standard UHC Choice Plus Silver 4850
- Standard UHC Choice Plus Bronze 7500
- UHC Choice Plus HSA Bronze 7100
- UHC Choice Plus HSA Bronze 6350
- Core Essential HMO Plans
- Standard UHC Core Essential Platinum 0-4
- Standard UHC Core Essential Gold 500
- Standard UHC Core Essential Silver 4850
- Standard UHC Core Essential Bronze 7500
- UHC Core Essential HSA Bronze 6350
- Optimum Choice (OCI) HMO Plans
Insurance coverage provided by or through UnitedHealthcare Insurance Company depending on the plan selected. Health plan coverage provided by or through Optimum Choice, Inc. or UnitedHealthcare of the Mid-Atlantic, Inc. depending on the plan selected.
- 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:- UHC Choice HSA Bronze 7100-2
- UHC OCI HSA Bronze 7100-2
- UHC Choice Plus HSA Bronze 7100-2
- UHC Core Essential HSA Bronze 7100-2
Insurance coverage provided by or through UnitedHealthcare Insurance Company depending on the plan selected. Health Plan coverage provided by or through Optimum Choice, Inc., MAMSI Life and Health Insurance Company and UnitedHealthcare of the Mid-Atlantic, Inc. depending on the plan selected.
Insurance coverage provided by or through UnitedHealthcare Insurance Company.
Oxford insurance products are underwritten by Oxford Health Insurance, Inc.
2024 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 (OCI) HMO Plans
- Standard UHC OCI Platinum 0-1
- UHC OCI Platinum 500
- Standard UHC OCI Gold 500
- Standard UHC OCI Silver 4850
- Standard UHC OCI Bronze 7500
- UHC OCI HSA Bronze 7100
- Standard UHC OCI HSA Bronze 6350
- Standard UHC OCI Platinum 0-1
- Choice and Choice Plus Plans
- Standard UHC Choice Plus Platinum 0-4
- UHC Choice Platinum 500
- UHC Choice Gold 750-1
- Standard UHC Choice Plus Gold 500
- Standard UHC Choice Plus Silver 4850
- Standard UHC Choice Plus Bronze 7500
- UHC Choice HSA Bronze 7100-1
- Standard UHC Choice Plus HSA Bronze 6350
- Core Essential HMO and Navigate Plans
- Standard UHC Core Essential Platinum 0-4
- Standard UHC Core Essential Gold 500
- Standard UHC Core Essential Silver 4850
- Standard UHC Core Essential Bronze 7500
- UHC Core Essential HSA Bronze 7100
- UHC Navigate HSA Bronze 7100
- Standard UHC Core Essential HSA Bronze 6350
- Optimum Choice (OCI) HMO Plans
Insurance coverage provided by or through UnitedHealthcare Insurance Company depending on the plan selected. Health plan coverage provided by or through Optimum Choice, Inc. or UnitedHealthcare of the Mid-Atlantic, Inc. depending on the plan selected.
- 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:- UHC Choice HSA Bronze 7100-2
- UHC OCI HSA Bronze 7100-2
- UHC Choice Plus HSA Bronze 7100-2
Insurance coverage provided by or through UnitedHealthcare Insurance Company depending on the plan selected. Health Plan coverage provided by or through Optimum Choice, Inc., MAMSI Life and Health Insurance Company and UnitedHealthcare of the Mid-Atlantic, Inc. depending on the plan selected.
Insurance coverage provided by or through UnitedHealthcare Insurance Company.
Oxford insurance products are underwritten by Oxford Health Insurance, Inc.
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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