Prescription Drug Formulary Lists January 28, 2025 Please find below the lists of covered and excluded prescription drugs as well as the list of preventive medications for participants of the High Deductible Plan. These medications by-pass the deductible and you pay the associated co-pay. 2025 - Formulary list of Covered Prescription Drugs.pdf641.85 KB 2025 - Formulary list of Excluded Prescripton Drugs.pdf321.98 KB 2025 - Formulary list of Preventive Medications for all plans.pdf639.78 KB 2025 - Formulary list of Preventive Medications for participants covered by the High Deductible Health Plan.pdf227.22 KB 2024 - Formulary list of Covered Prescription Drugs.pdf1.21 MB 2024 - Formulary list of Excluded Prescription Drugs.pdf332.96 KB 2024 - Formulary list of Preventive Medications for participants covered by the High Deductible Health Plan.pdf527.47 KB