Prescription Drug Lists (PDLs) for UnitedHealthcare Individual & Family ACA Marketplace plans

Effective January 1, 2023 & January 1, 2024

A Prescription Drug List (PDL) or a formulary is a list of covered prescribed medications or supplies. The PDL includes information you need, like: 

  • If your medication is covered
  • What tier your medication is considered under your plan
  • If your medication has coverage requirements or limits, like prior authorization, step therapy or quantity limits 

Choose a medication in Tier 1 or Tier 2 for your lowest cost options. If your medication is in a higher tier, you may pay more. Ask your health care provider if a lower cost medication can work to treat your condition.

If your medication is not covered or has a coverage requirement or limit, talk to your health care provider. They may be able to ask about a prior authorization or exception to get your medication covered or may switch you to a covered medication that can treat your condition.

When to use the Medication Search or PDF formats of the Prescription Drug list:

  • For up-to-date coverage information, search for medications using the Medication Search.
  • Use the PDF to learn about the drug list, tier information, and coverage requirements or limits such as prior authorization, step therapy, and quantity limits. The PDF also explains how to request a prior authorization or exception.

Managing your pharmacy benefits

If you're a member with an Individual & Family Marketplace ACA plan, explore these tips for using and managing your pharmacy benefits. 

Learn about pharmacy benefits for ACA plans

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