Updates to the Covered Drug Lists
Check below for information about recent changes to the list of drugs covered under your formulary. Your member ID card will list your formulary. If your member ID card does not have a formulary listed, you have Formulary 1.
Drug Coverage Change Overview for 2025-2026 (applies to formulary 1, 2, and 5)
CDPHP Formulary 1
Formulary 1 is the list of drugs available to CDPHP members with large group coverage. It is updated periodically.
CDPHP Formulary 2
Formulary 2 is the list of drugs available to CDPHP members with small group, individual coverage, or essential plan.
CDPHP Formulary 3 - New
Formulary 3 is the list of drugs available to CDPHP members with large group and self-funded coverage. It is updated periodically.
CDPHP Formulary 4 - New
Formulary 4 is the list of drugs available to CDPHP members with small group, individual coverage, or essential plan.
CDPHP Formulary 5
Formulary 5 is the list of drugs available to CDPHP members with self-insured coverage with a 5 Tier benefit design. It is updated periodically.
Medical Benefit Formulary/Prior Authorization Medications
The following guideline includes most, but not all, provider administered injectable medications and pharmaceutical agents.
Medicaid Drug Coverage
Beginning April 1, 2023, all members enrolled in CDPHP Medicaid will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program.
For more information about the Medicaid pharmacy benefit transition from CDPHP to NYRx, visit the pharmacy benefit transition webpage.
To learn more about NYRx, the Medicaid Pharmacy Program, visit the New York State Department of Health NYRx website, where information for both for members and providers is also available.
Medicaid Drug Coverage Policies