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Pharmacy & Drugs

A prescription drug benefit with broad prescription drug coverage is included in our group health plans.
Effective Jan. 1, 2025: Capital Rx will serve as the Pharmacy Benefits Administrator for Baylor Scott & White Health Plan. Learn more about this change and what it will mean for your groups and members on our Capital Rx page.

Formularies: Lists of covered prescription drugs

Pharmacy benefit information for:

Small Group Employer Members
(Gold, Silver or Bronze Plans)

Small Group Employer/My Plan PPO Individual Members
(Transitional Plans)

Large Groups

Pharmacy Locator and Drug Cost Calculator 

Select a plan to check the costs of your medications, look-up drug coverage and search for pharmacies.

Group Plans

Individual

Pharmacy Benefit Resources and Education

ACA Preventive Care Medications

Under the Affordable Care Act, also known as the healthcare reform law, BSWHP covers preventive care medications at 100% without charging a copay, coinsurance or deductible. The following list of drugs and products require a prescription (including over-the-counter medications) and must be filled at a network pharmacy to be covered at no cost share.

Specialty Pharmacy Drug Program

The Specialty Pharmacy Drug Program offers the choice of two specialty care pharmacies to help manage and access specialty drugs.

Upcoming Formulary Changes

BSWHP Medications Restricted to Pharmacy or Medical Benefit

BSWHP has certain medications that are restricted to the Pharmacy or Medical Benefit. For more information on these medications, visit the link below. :

Pharmacy Information and Locations

Provider Directory and Pharmacy Locator

For 2024 pharmacy claim reimbursement requests, view the 2024 Pharmacy Claim Form.

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