Which prescription drugs are covered by Obamacare health insurance in Arizona?

Depending on which part of Arizona you live in, Affordable Care Act plans (aka Obamacare) are available in 2021 from the following companies: Ambetter, Blue Cross Blue Shield, Bright Health, Cigna, Oscar Health, and United Healthcare.

All of these options are available in the Phoenix/ Maricopa county area. In the Tucson/ Pima county area, the options are Ambetter, Blue Cross Blue Shield, and Bright Health. Outside of the Phoenix or Tucson metro areas, the options vary.

Each insurance company has its own drug formulary, or list of drugs that are covered. The drugs are divided into 4 levels, or tiers:
Tier 1: Lowest cost (Most generic drugs are in level 1)
Tier 2: Medium cost (Preferred brand-name drugs are in level 2)
Tier 3: Higher cost (NON-preferred brand-name drugs are in level 3)
Tier 4: Highest cost drugs (Speciality drugs)

If you visit healthcare.gov and get information about the various Obamacare options available to you, you can also enter your prescription drugs to see if they are covered. Unfortunately, the only information you will receive is whether or not a drug is “covered” or “not covered” by a particular plan. It does not tell you under which Tier the drug is listed. For example, a “covered” drug could be listed in Tier 2 on one plan and cost you $75, while the same drug could be listed in Tier 3 on a different plan and cost you $500.

Here are links to each company’s 2021 drug formulary to help you figure out the cost of your prescription drugs.

Please note that the formularies for the ACA Obamacare plans above may be different than the formularies you may find for one of these company’s other plans, such as a group plan through an employer or a plan available for a state other than Arizona.

For help figuring out the exact cost of your prescription drugs, as well as detailed guidance on which Arizona health insurance plan is right for you, give us a call at 1-800-600-9663 or fill out our online form and we will get in touch with you right away.

Author: Chad Lehrman
Arizona health insurance broker for individuals & families. Click here to schedule a call with me.