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Jefferson health plans special

Effective Date: Jan 1, 2024
Last Updated: Nov 21, 2024

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.

Legend

  • T1
    - Covered
  • NF
    -
  • QL
    - Quantity Limit
  • PA
    - Prior Authorization
  • PA2
    - Prior Authorization (New Starts Only)
  • PA3
    - Prior Authorization (Part B vs. Part D)
  • ST
    - Step Therapy
  • $0 CS
    - $0 Cost Share
  • NDS
    - Non-Extended Day Supply
† Denotes brand name drug, otherwise generic drug