PacificSource Drug Lists

The PacificSource drug lists are guides to help your doctor identify medications that can provide the best clinical results at the lowest cost. As a cost savings for you, generic drugs are included in place of name brand drugs wherever possible. Please note that drugs not listed on the drug list are not covered. Drug lists are subject to change as new drugs enter the market. See Drug News for recent changes.

General Information 


Utilization Management Policies 


Which drug list do I choose?

  • If you're a current PacificSource member, check your ID card (see example) to see which drug list you should choose. If no drug list is noted, please choose the PDL.
  • If you're shopping for individual coverage (not a current member), choose the state drug list for the state in which you reside (ID, MT, OR).
  • If you're shopping for group coverage, choose the state drug list for the state where the employer is headquartered (ID, MT, OR).
Learn more about our drug lists >
member ID card with drug list info

Pick a drug list

Please note: Some plans only provide coverage for certain drugs on this list. A separate benefit may apply to some drugs, such as specialty drugs. If you have questions about your coverage, please contact our Customer Service Department at (888) 977-9299 or by email at

If your drug is not included in this drug search, you should first contact customer service and confirm that your drug is not covered. You and your doctor have the right to request an exception to the plan’s formulary or coverage criteria. If you would like to request an exception, please have your doctor submit documentation through InTouch, fax, or phone using the Preauthorization/Medication Exception Request.