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2021 Formulary Premera Com
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Essentials Formulary E1/E4 Effective 12-01-2021
www.premera.comFormulary Drugs include Generic (1), Preferred Brand (2), Preferred Specialty (3) and Non-Preferred (4) Drugs. Medical plan cost shares apply to formulary drugs. Once you have satisfied your medical deductible, you will pay your applicable coinsurance until you reach your out of pocket maximum limit. Essentials E4 Formulary Drug Tier Includes