To see our formulary, or list of covered drugs, choose your plan from the list below.
2025 Colorado Marketplace Formulary (PDF)
For non-grandfathered small group plans purchased through Kaiser Permanente or Connect for Health Colorado, the insurance marketplace.
2024 - 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 - 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.
2024 - 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 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 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 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 - 2025 Specialty tier drug list (PDF)
This list of specialty drugs applies to plans that follow the Colorado Self-Funded/Level-Funded/EPO Formulary.
2024 - 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 Preferred Drug List (Spanish) (PDF)
For those enrolled in a Point of Service, Preferred Provider Organization, Choice Preferred Provider Organization or Choice Out of Area plan.
Use this formulary if you have a Kaiser Permanente Medicare health plan.
Drugs that aren’t listed on the formulary, known as nonformulary drugs, aren’t covered by your plan. For nonformulary drugs, you have the following options:
You can pay full retail price for the prescription.
You can use your network pharmacy benefit, if applicable.
You can ask your doctor to prescribe a similar drug that’s included on our formulary.
You can ask your doctor to request an exception so your non-formulary drug can be covered by your prescription drug benefit.
The most effective way to get an exception to the formulary is to send a secure email to your doctor.
You can also call Member Services, Monday through Friday, 8 a.m. to 6 p.m., at:
Prior Authorization of Outpatient Prescription Drugs (for certain drugs, step therapies, age, provider, and quantity limits for the HMO lines of business):
Outpatient prescriptions drugs included on the drug formularies are covered, however certain drugs require authorization prior to being covered. To ensure that a drug is medically necessary and cost effective, members or their providers will need to get prior authorization for certain outpatient prescription drugs that are included on the drug formulary, as well as for all drugs that are not included on the drug formulary. Your provider should request prior authorization by completing and submitting the KPCO HMO Medication Request Form to the KPCO Pharmacy Authorization Service by faxing the form to 1-858-357-2615.
Find out which drugs are covered, and which ones require prior authorization by viewing the drug formularies at Covered drugs – Colorado/Kaiser Permanente The HMO drug formularies are based on the specific benefit plans, such as a Marketplace plan purchased on the exchange, a Federal Employee Health Benefit (FEHB), a large group employer HMO plan or an employer Self-Funded plan. Each formulary may have different limitations, restrictions, and rules for coverage.
To see what clinical criteria are required for a drug requiring prior authorization click here.
To see data regarding approvals and denials of prior authorization requests for outpatient prescription drugs click here.
In compliance with Colorado Revised Statue 10-16-145, a provider may submit the Mental Health Illness Step Therapy Exception Form for any drug to treat a mental illness that requires step therapy on any of our commercial formularies. If all criteria for the exception are met the drug will be approved without requiring additional step therapy requirements. The form can be faxed to the KPCO Pharmacy Authorization Service Team at 1-858-357-2615.
For more information or to receive a copy of our drug formulary, please contact Member Services at one of the numbers below, Monday through Friday, from 8 a.m. to 6 p.m.:
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