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Essential

Welcome

Welcome to the SmithRx Essential Formulary. The Essential Formulary is a list of drugs that your doctor may prescribe for you and includes information related to the coverage and cost of these drugs. This list may change over time, so please refer to plan documents or formulary update documents for detailed information about your drug benefit coverage. Our Pharmacy and Therapeutics Committee (P&T) dedicates many hours to the clinical analysis and evaluation of peer reviewed literature and medical care guidelines to determine a drug’s safety and efficacy. After this rigorous clinical evaluation, the committee weighs the financial implications of a drug compared to other similar drugs and selects appropriate Tier placement based on the drugs’ safety, efficacy and cost- effectiveness. Please note all drugs on the SmithRx Essential Formulary are subjected to periodic review and amendment. Please keep in mind when a generic medication is chosen, patients pay the lowest copay available under their pharmacy benefit plan. When clinically appropriate, please consider talking to your doctor about choosing a generic product.

PLEASE NOTE: This drug lookup tool provides general reference information only and does not guarantee or imply coverage or payment for any medication. Specific benefit designs may vary with respect to drug coverage & exclusions, formulary updates throughout the year, member cost share, quantity limits, days supply, and prior authorization. Please consult your plan documents and/or call the number listed on your member ID card if you have questions about your specific prescription drug benefits.

Formulary Tool Instructions

How to Search For Drugs

  • Use the alphabetical list to search by the first letter of your medication.
  • Search by typing part of the generic (chemical) and brand (trade) names.
  • Search by selecting the therapeutic class of the medication you are looking for.

    • Printable Files

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    1/1/2026 Essential Formulary

    How to Request an Exception

    You can ask us to make an exception to our coverage rules. There are several types of exceptions that you can ask us to make:
  • You can ask us to cover your drug even if it is not on our formulary.
  • You can ask us to waive coverage restrictions or limits on your drug.
  • You can ask us to provide a higher level of coverage for your drug.

    • You should contact us to ask us for an initial coverage decision for a formulary, tiering or utilization restriction exception. When you are requesting a formulary, tiering or utilization restriction exception you should submit a statement from your physician supporting your request.

    Legend

    TIERING
    • T0
      - OTC
    • T1
      - Generics
    • T2
      - Preferred Brands
    • T3
      - Non-Preferred Brands
    • T4
      - Preferred Specialty
    • T5
      - Specialty
    • NF
      - Non-Formulary
    Edits
    • QL
      - Quantity Limit
    • PA
      - Prior Authorization
    • ST
      - Step Therapy
    • GL
      - Gender Limit
    • AL1
      - Age Limit
    • S
      - Specialty Drug
    • MED
      - Medical Drug
    • ACA
      - Affordable Care Act
    • NEG
      - Non-Essential Generic
    • NEB
      - Non-Essential Brand
    • MSB
      - Multisource Brand
    • HCG
      - High Cost Generic
    • PREV
      - Preventative
    • OP
      - Opioid Program
    † Denotes brand name drug, otherwise generic drug
    Brand Names
    generic names
    Essential
    Effective Date: Jan 1, 2021
    Last Updated: Oct 27, 2025