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Prescription Drug List (PDL)


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Prescription Drug Lists

A Prescription Drug List (PDL) is a list of Food and Drug Administration (FDA)-approved brand name and generic medications. It is the foundation for how we drive value for our customers and members.

Your UnitedHealthcare pharmacy benefit provides coverage for a comprehensive selection of prescription medications. In the links below you will find some commonly prescribed medications for certain conditions. You and your doctor may refer to these lists to select the right medication to meet your needs.

Both the Traditional PDL and Advantage PDL are developed through an evidence-based evaluation process that enables us to place the highest value medications in lower copay tiers and align an individual’s cost share with the relative value of the medication.

On the Traditional PDL, medications may move to a higher tier once per calendar year (January 1). On the Advantage PDL, medications may move to a higher tier up to six times per calendar year.

Anytime a brand name medication becomes available as a generic, the tier status of the brand name medication will be evaluated. On the Traditional PDL, generics are automatically placed in Tier 1. On the Advantage PDL, generics are placed in whatever tier is appropriate based on the medication’s overall value. When a medication changes tiers, you may be required to pay more or less for that medication. These changes may occur without prior notice to you.

The benefit plan documents provided by your employer or health plan include a Summary Plan Description (SPD) or a Certificate of Coverage (COC). Please refer to these documents to determine which medications are covered under your individual plan. For the most current information on your pharmacy coverage, please call the Customer Care number on your ID card or go to the Online Pharmacy.