Pharmacy Coverage for 2025 Health Plans

Shopping for a 2025 health plan?

Individual & Family and Small Employer Plans

If you choose an Individual & Family plan, or will get insurance through a Small Employer (employers with 50 or fewer eligible employees*), your formulary is RxCore. Most plans use the RxCore Five-tier (5T) formulary (the list of drugs covered by your health insurance). Other plan use Four-tier (4T) or Six-tier (6T) drug lists. As tiers get higher, drugs typically cost more and your copays or coinsurance may increase. If you and your doctor find drugs on lower tiers that effectively treat your symptoms, you will usually pay less.

Use the links below to search for medications that will be covered when you enroll or renew your plan in 2025.

Individual & Family Plans

RxCore 5 Tier

Explore 5-tier coverage for Utah and Idaho Individual & Family Plans.

RxCore 6 Tier

Explore 6-tier coverage for Colorado and Nevada Individual & Family Plans.
Small Employer Plans

RxCore 5 Tier

Explore 5-tier coverage for Utah and Idaho Small Employer Plans.


*some states definition of a Small Employer may differ.

Standardized & Option Plans

In Utah and Colorado, state regulations require that some Individual & Family plans have a specific formulary option. In Utah, these plans are called Standardized Plans. In Colorado, they are called Option Plans. If you choose one of these plans for your 2025 coverage, links to your covered drug list are shown below. The Utah option uses a four-tier drug list and the Colorado option uses a five-tier.