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Drug search


Here's where to learn which drugs your plan covers. You can also see whether a drug is brand-name or generic and learn of any restrictions for its use.

Drug lists are reviewed monthly. Latest update: 6/1/2023

For a complete, printable drug list, choose "View/Print Drug List" at left.


Home delivery


Save money with CVS Caremark mail order.

  • $0 copay on preferred generic (Tier 1) and select care drugs (Tier 6). Does not apply to PERS plan.
  • 90-day supply for 60-day cost for generic (Tier 2) and preferred brand (Tier 3). Does not apply to PERS plan.
  • Free shipping and optional auto-refills

To have your prescriptions filled at our Preferred mail-order pharmacy, please use the mail-order form, register online , or call.

CVS Caremark Mail-Order Services
Register online at: www.CareMark.com
Toll-Free: 866-362-4009
TTY/TDD: 711

Pay $0 for many popular prescriptions


Select Care (Tier 6) drugs are included in your prescription plan, and you'll pay $0 for up to a 90-day supply at preferred pharmacies. These drugs treat conditions related to blood pressure, cholesterol, diabetes, and more.

Note: Does not apply to PERS plan. See PERS drug list at left.


About generics


PacificSource Medicare plans cover both brand and generic drugs. Generic drugs have the same active ingredient as a brand-name drug. Generics usually cost less and are determined by the Food and Drug Administration (FDA) to be as safe and effective as their brand-name counterparts.

Utilization management


For certain prescriptions there are additional requirements or limits. Learn more about utilization management, including prior authorization, quantity limits, and step therapy:


Your rights


You and your doctor have the right to request an exception to the plan’s formulary or coverage criteria. If your drug is not included in this drug search, you should first contact Customer Service and confirm that your drug is not covered. If you learn that your PacificSource Medicare plan does not cover your drug, you have two options:

  1. You can ask Customer Service for a list of similar drugs that are covered by PacificSource Medicare. When you receive the list, show it to your doctor and ask them to prescribe a similar drug that is covered by PacificSource Medicare.
  2. If you would like to request an exception, please contact the PacificSource Medicare Customer Service Department.

Quality assurance


To help ensure the safety of our members, PacificSource Medicare has adopted a Drug Utilization Review and Medication Error Identification and Reduction policy.


The list of covered drugs (formulary) may change at any time. You will receive notice when necessary. Other pharmacies are available in our network.