Prescription Drug Resources

Including Medical Mutual’s advanced pharmacy management with your medical plan gives you access to a variety of innovative programs that go beyond drug discounts to improve clinical outcomes and member experience. This helps ensure you are effectively managing both your employees’ health and your overall healthcare expenses. A brief overview of many of these programs is available here. Medical Mutual partners with Express Scripts (ESI), our pharmacy benefit manager, to help you and your (family/employees/patients) manage prescription drug benefits.

Formulary Drug Lists

All insurance plans have a list of prescription drugs they cover, known as a formulary. From the links below, you can review our standard 2024 and 2025 formularies or visit ESI to see medication coverage information in real time for prospective members. 

2024 Basic Plus (Medical Mutual Commercial and MHS Plans)

2024 National Preferred (Select Self-funded Plans)

2024 ACA Advantage Formulary

2025 Basic Plus (Medical Mutual Commercial and MHS Plans)

2025 National Preferred (Select Self-funded Plans)

2025 ACA Advantage Formulary

For Existing Members

Covered employees can also view your plan’s selected formulary through My Health Plan as an interactive tool that displays the formulary status and pricing information of every medication. Please keep in mind that certain drugs may be subject to coverage management rules.

Online Resources

By visiting the Prescription Drug Benefits page on My Health Plan, covered employees have access to a variety of resources to help them manage their prescription needs:

  • Order refills – Your employees can submit requests for mail-order refills and monitor the status of their prescription shipments, online, by phone or by mail. They can also ask their provider to submit a refill request by fax.
  • Prescription history – Lets your employees view secure information about their past prescriptions.
  • Pharmacy locator – This tool helps your employees find a participating pharmacy near their home, office or daily commute. 

In addition, a smartphone app allows employees to discuss lower-cost medication options with their providers while still in the exam room and request prescription refills and renewals from their phone.