Drugs Formulary

The Drug Formulary includes a guide of drugs covered under your prescription drug plan.

Identify your Formulary

Your plan membership card will help you identify the drugs formulary that applies to you.
The image is just an example. The insurance card’s design may be changed or modified.

Essential Health Benefits (EHB) Drug Formulary

This formulary applies to members with the following details in their card, effective for 2024 benefits:

MCS Personal Directo – Group # starting with 79-65xxxx and a benefits package between 6318 to 6357.

EHB Formulary 2024

EHB Formulary 2023

*If your benefit package is not included in the above information, please refer to 2023 formularies.

To assure the formulary that applies to your benefit, please refer to your policy or benefit certificate.

PDL Drug Formulary

An open formulary is a list of preferred medication, where you have access to all the medication. Nevertheless, the medication that is not on the preferred list will pay a higher copay or coinsurance than that medication included.

This 2024 Formulary applies to insureds whose group numbers differ from

79-65XXXX or 79-67XXXX.

2024 Formulary

2023 Formulary

*If your benefit is effective in 2023, please refer to 2023 formularies.
To assure the formulary that applies to your benefit, please refer to your policy or benefit certificate.

Value Drug Formulary

This Formulary applies for 2024, to members with the following details in their card:

MCS Global Essential- Group # starting with 79-67xxxx and Benefit Package between 9196-9219.
MCS Global Premium- Group # starting with 79-67xxxx and Benefit Package between 9220-9279.
MCS Global Elite - Group # starting with 79-67xxxx and benefit package between 9280-9351.
For Large Group Products- may apply for some groups, please refer to your benefit certificate.