Are You a Member?
Log in to the Member Portal to find covered drugs or a pharmacy that works with your plan.
List of Covered Drugs
Find out what prescriptions are covered under your AvMed plan using the formularies (prescription drug lists).
If you get your insurance through work, see the list of covered drugs below.
Drugs Covered by Employer-Sponsored Plans (Formularies)
2025 Pharmacy Benefits Plans Tool (Last Modified January 1, 2025)
2025 5-Tier Drugs Covered by Fully Insured Large Group Employer Plans (Last Modified October 1, 2025)
2025 5-Tier Drugs Covered by GHT MEWA Employer Plans (Last Modified October 1, 2025)
2026 5-Tier Drugs Covered by Small Group ACA Employer Plans (Last Modified January 1, 2026)
For the following group plans: Elect, Elite, Elite Choice, Flex, Focus
2025 5-Tier Drugs Covered by Small Group ACA Employer Plans (Last Modified October 1, 2025)
For the following group plans: Elect, Elite, Elite Choice, Flex, Focus
2025 4-Tier Drugs Covered by Fully Insured Large Group Employer Plans and KYP Plans (Last Modified October 1, 2025)
2025 4-Tier Drugs Covered by Self-Funded Employer Plans - City of Sunrise (Last Modified October 1, 2025)
Preferred Pharmacy Drug List for Sentara Health Members in Florida
Find your list of covered drugs if you have an AvMed Marketplace plan or a plan directly through AvMed.
Covered Drugs (Formularies)
2026 Covered Drugs (5-Tier Formulary) (Effective January 1, 2026)2026 Covered Drugs (4-Tier Formulary) (Effective January 1, 2026)
2025 Pharmacy Benefits Plans Tool (Last Modified January 1, 2025)
2025 Covered Drugs (5-Tier Formulary) (Effective October 1, 2025)
2025 Covered Drugs (4-Tier Formulary) (Effective October 1, 2025)
For the following Individual and Family plans: Empower, Engage, Entrust and Entrust Plus.
Pharmacy Resources
Forms & Information - Individual and Family
Medical Benefit Drugs Requiring Prior Authorization
Medical Drug Authorization Request Form
Pharmacy Drug Mail Order Form (English)
Pharmacy Drug Mail Order Form (Spanish)
Pharmacy Member Reimbursement Form
Pharmacy Drug Authorization Forms by Drug and Class
Coverage requests for drugs requiring prior authorization must be submitted using either the drug-specific or class specific form (if applicable).
If you have questions or need information on how to obtain a copy of AvMed’s decision-making criteria, please call AvMed’s Provider Service Center at 1-800-452-8633, Option 3, for assistance.
Rx Saving Solutions
Get access to offers and alerts that can help reduce your out-of-pocket prescription costs.