Drug Coverage
Cigna covers thousands of drug prescriptions, all intended to give your patients the best value. Use the tools and lists below to find pricing and coverage information for any prescription your patient might need.
- Check patient-specific eligibility and benefits on CignaforHCP
- Submit online prior authorization requests on PromptPA
- Cigna Formulary for Individual and Family Plans
- Cigna Formulary for Employees
- Cigna-HealthSpring Medicare PartD Formulary
- Cigna Commercial Formulary Updates
Preferred Specialty Drug Lists
Submit an online prior authorization request for prescription drugs covered under the Cigna pharmacy benefit1 at PromptPA.
| Therapeutic Class | Medication |
|---|---|
|
Growth Hormones |
Humatrope |
|
Hepatitis C Antivirals |
Epclusa |
|
Infertility Agents |
Follistim AQ |
|
Biologic Immunomodulator Agents |
Actemra |
|
Viscosupplement Agents |
Monovisc |
|
Oncology |
Fulphila |
Limited Distribution Drug (LDD) List
Cigna Specialty Pharmacy ServicesSM has access to the majority of Limited Distribution Drugs (LDDs) through agreements with several manufacturers. Currently, Cigna utilizes a contracted pharmacy network to help ensure that customers have access to most required medications.
In the event our pharmacy does not have or is unable to obtain access to a particular medication, we will leverage our pharmacy network to contract with a pharmacy in order to provide the medication to the customer or prescriber.
Effective for new prior authorizations obtained on or after May 1, 2018, Cigna will no longer reimburse facilities that bill us for the cost of certain LDDs that are purchased directly from specialty pharmacies, manufacturers or wholesalers. We will require a Cigna-contracted specialty pharmacy to dispense these LDDs and submit the claim to Cigna. For additional information on this LDD reimbursement change for facilities, including the list of affected LDDs, please review the Cigna Reference Guide for Physicians, Hospitals, Ancillaries, and Other Health Care Professionals. To access this guide, log in to the Cigna for Health Care Professionals website (CignaforHCP.com > Resources > Reference Guides). We recommend you check this list frequently, as additional drugs may be added.
You can read more about this LDD reimbursement change for facilities in the Cigna Reference Guide for participating physicians, hospitals, ancillaries, and other health care professionals. Log in to CignaforHCP.com > Resources > Reference Guides > Medical Reference Guides > Health Care Professional Reference Guides.
Updates
1Preferred Specialty Drug Lists requirements:
- It is the decision of the prescribing physician in the exercise of his/her independent clinical judgment to determine which medication to prescribe. Coverage is not limited to the preferred drug.
- Cigna may receive payments from manufacturers whose medications are included on the Cigna Preferred Specialty Drug List. These payments may or may not be shared with the member's benefit plan dependent on the contractual arrangement between the plan and Cigna.
- Depending upon plan design, market conditions, the extent to which manufacturers' payments are shared with the member's benefit plan, and other factors as of the date of service, the preferred medication may or may not represent the lowest cost medication within the therapeutic class for the member and/or the benefit plan.
- Cigna reserves the right to make changes to this Preferred Specialty (Injectable) Drug List without notice.