Visit our pharmacy locator to search for participating pharmacies near you.
Pharmacy benefits
Our pharmacy benefits are built for choice, savings, and convenience.
Where can I find information specific to my plan?
Mass General Brigham Health Plan covers a wide variety of safe and effective medications for treating our members' medical needs.
If your employer provides pharmacy benefits through Mass General Brigham Health Plan or if you purchased a health plan through the Massachusetts Health Connector or our intermediary partners, keep reading on this page to get to know some helpful information about your pharmacy benefits. If you are a Medicare Advantage or Mass General Brigham ACO member, you can get to know your plan benefits at the links below.
If you do not get your pharmacy benefits through us, contact your employer for information about your pharmacy coverage.
Get to know our commercial pharmacy benefits
We partner with Optum Rx® to manage pharmacy benefits for our members. Members can fill prescription medications at any pharmacy in our national network which includes most major chains like CVS Pharmacy®, Walgreens® and Rite Aid®, as well as grocery store pharmacies and many independent pharmacies across the United States.
Find a pharmacy
Find a pharmacy
Search for covered drugs
Our pharmacy programs sort drugs into tiers based on their cost. Many of our plans include the 6-tier pharmacy program, which sorts drugs into 6 different cost tiers. Other plans include the 4-tier or 3-tier pharmacy program. Below you'll find the drug lookup for each of our pharmacy programs, along with other prescription benefits that come as part of the program included with your plan.
If you're not sure which pharmacy program is included with your plan, you can find out in your Schedule of Benefits. Current members can view this document by signing in to the Member Portal.
Find covered drugs
- 2025 Drug lookup
- 2025 6-tier Formulary PDF
- Low cost drug list - Find a list of drugs in the low-cost generic drug tier for your plan.
Learn about your pharmacy benefits
Find covered drugs
- 2025 Drug lookup
- 2025 4-tier Formulary PDF
- Low cost drug list - Find a list of drugs in the low-cost generic drug tier for your plan.
Learn about your pharmacy benefits
Find covered drugs
Learn about your pharmacy benefits
Medication updates
Medication updates
Additional pharmacy benefit information
Chronic condition medications
Members with pharmacy benefits through Mass General Brigham Health Plan are entitled to fill certain medications used to treat chronic conditions at the listed cost share under Chapter 342 of the Acts of 2024, An Act relative to pharmaceutical access, costs and transparency (PACT ACT).
Generic $0 | Brand ≤$25 | |
Asthma | Montelukast tablets, chews, and granules | Symbicort |
Heart Condition | Lisinopril | Diovan* |
Heart Condition | Atorvastatin | Praluent* |
Diabetes | N/A | Humalog, Lyumjev, Insulin Lispro |
Diabetes | N/A | Humulin R |
Diabetes | N/A | Humulin N |
Diabetes | N/A | Lantus |
Diabetes | N/A | Toujeo |
Diabetes | N/A | Humulin Mix, Humalog Mix, Insulin Lispro Mix |
*May require prior authorization. **May not apply to ASO plans. ***HSA plans: Deductible may still apply
Prescription contraceptive coverage
Members with pharmacy benefits through Mass General Brigham Health Plan and Mass General Brigham ACO are entitled to fill a 12-month supply of prescription contraceptives under Chapter 120 of the Acts of 2017, An Act Relative to Advancing Contraceptive Coverage and Economic Security in Our State (ACCESS).
To find out about your options, please speak to your provider or pharmacist.
11 No-cost drugs
For plans that include Care Complement benefits, the following common prescription medications to treat depression, heart conditions, and high blood pressure have $0 cost for members.*
- Depression: Fluoxetine 10mg, 20mg capsules
- Diabetes: Metformin, regular release tablets
- High cholesterol: Atorvastatin tablets, Simvastatin tablets
- Heart and high blood pressure: Amlodipine besylate tablets, Atenolol tablets, Furosemide tablets, Lisinopril tablets, Losartan tablets, Hydrochlorothiazide 12.5mg capsule, 25mg, 50mg tablets, Metoprolol succinate SR tablets
*Does not apply to HSA plans.
Pain management information
Pain management information
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and Mass General Brigham Health Insurance Company