Pharmacy

2025 Colorado Marketplace Formulary (PDF)
For non-grandfathered small group plans purchased through Kaiser Permanente or Connect for Health Colorado, the insurance marketplace.

2025 Specialty Tier Drug List (PDF)
This list of specialty drugs applies to plans that follow the Colorado Marketplace Formulary.

2025 Colorado Specialty Pharmacy Info (PDF)
This lists information on where to obtain certain specialty drugs for members on a commercial plan.

2025 Preventive Tier Drug List (PDF)
This list of preventive drugs applies to any commercial plan that has chosen a benefit to allow preventive drugs to be offered at a reduced cost share to the member. Please refer to your prescription drug benefit plan details to determine if this benefit applies to you.

2025 Colorado Commercial HMO Formulary (PDF)
For mid or large group employer plans or a plan that is considered grandfathered.

2025 Specialty Tier Drug List (PDF)
This list of specialty drugs applies to plans that follow the Colorado Commercial HMO.

2025 Colorado Specialty Pharmacy Info (PDF)
This lists information on where to obtain certain specialty drugs for members on a commercial plan.

2025 Preventive Tier Drug List (PDF)
This list of preventive drugs applies to any commercial plan that has chosen a benefit to allow preventive drugs to be offered at a reduced cost share to the member. Please refer to your prescription drug benefit plan details to determine if this benefit applies to you.

2025 Colorado Marketplace Formulary (PDF)
For non-grandfathered small group plans purchased through Kaiser Permanente or Connect for Health Colorado, the insurance marketplace.

2025 Specialty Tier Drug List (PDF)
This list of specialty drugs applies to plans that follow the Colorado Commercial HMO.

2025 Colorado Specialty Pharmacy Info (PDF)
This lists information on where to obtain certain specialty drugs for members on a commercial plan.

2025 Preventive Tier Drug List (PDF)
This list of preventive drugs applies to any commercial plan that has chosen a benefit to allow preventive drugs to be offered at a reduced cost share to the member. Please refer to your prescription drug benefit plan details to determine if this benefit applies to you.

2025 Colorado Federal Employees Health Benefits (FEHB) Formulary (PDF)
For those enrolled in the Federal Employees Health Benefits (FEHB) plan.

2025 FEHB Prescription Drug Cost Lookup
Use this Drug Cost Look up tool if you are enrolled in the Federal Employees Health Benefits (FEHB) plan.

2025 Preventive Tier Drug List (PDF)
This list of preventive drugs applies to any commercial plan that has chosen a benefit to allow preventive drugs to be offered at a reduced cost share to the member. Please refer to your prescription drug benefit plan details to determine if this benefit applies to you.

2025 Colorado Specialty Pharmacy Info (PDF)
This lists information on where to obtain certain specialty drugs for members on a commercial plan.

2025 Colorado Postal Service Health Benefits (PSHB) (PDF)
For those enrolled in the Postal Service Health Benefits (PSHB) plan

2025 PSHB Prescription Drug Cost Lookup
Use this Drug Cost Look up tool if you are enrolled in the Postal Service Health Benefits (PSHB) plan

2025 Preventive Tier Drug List (PDF)
This list of preventive drugs applies to any commercial plan that has chosen a benefit to allow preventive drugs to be offered at a reduced cost share to the member. Please refer to your prescription drug benefit plan details to determine if this benefit applies to you.

2025 Colorado Specialty Pharmacy Info (PDF)
This lists information on where to obtain certain specialty drugs for members on a commercial plan.

2025 Colorado Self-Funded/Level-Funded/EPO Formulary (PDF)
For those enrolled in a Self-Funded or Level-Funded EPO plan.

2025 Colorado Level-Funded PPO/POS Formulary (PDF)
For those enrolled in a Level-Funded PPO or POS plan.

2025 Specialty Tier Drug List (PDF)
This list of specialty drugs applies to plans that follow the Colorado Self-Funded/Level-Funded/EPO Formulary.

2025 Preventive Tier Drug List (PDF)
This list of preventive drugs applies to any commercial plan that has chosen a benefit to allow preventive drugs to be offered at a reduced cost share to the member. Please refer to your prescription drug benefit plan details to determine if this benefit applies to you.

2024 Colorado Preferred Drug List (PDF)

For those enrolled in a Point of Service, Preferred Provider Organization, Choice Preferred Provider Organization or Choice Out of Area plan.

Medication Prior Authorization Requests

KPCO Pharmacy Authorization Guidelines

A coverage exception for a non-formulary or a restricted medication may be requested through one of the following:

Commercial benefit plans

Fax the commercial medication request form (MRF) to Kaiser Permanente

Medication Request form (MRF)

CO Serious Mental Illness Step Therapy Exception Form

Medicare benefit plans - EFFECTIVE 1/1/2021:

• Fax the Medicare Medication Request Form (MRF) to OptumRx at 1-844-403-1028 (or)
• Use SureScripts, within your electronic medical record (or)
• Use CoverMyMeds - this can link to the same document as above (or)
• Call OptumRx directly at: 1-888-791-7255, 8am to 8pm, 7 days a week.

Kaiser Permanente members can save significantly on their prescription medications – often the cost of one or two copays for a 90-day supply – when they use our mail order pharmacy service. It’s easy as easy as A B C for you to send your patients’ subscriptions to our mail order pharmacy – here’s the different options available to you:

A – If you use SureScript through your EMR, you can send the prescription/s electronically to Kaiser Permanente mail order pharmacy.
B – Call us at 1-866-523-6059 (TTY 711), Monday through Friday, 8 a.m. to 6 p.m.
C – Fax the written prescription/s to 1-866-551-9628

Once you’ve sent the prescription/s through to us, Kaiser Permanente members registered on kp.org can order their prescriptions for delivery within 3-5 days at kp.org/pharmacy – this only takes a moment and members need to have a credit card ready for payment. If a member prefers to call, they can speak to a mail order representative at 1-866-523-6059 (TTY 711), Monday through Friday, 8 a.m. to 6 p.m.