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Essentials Formulary E1/E4 Effective 12-01-2021
www.premera.comEssentials Formulary E1/E4 Effective 12-01-2021 . LIST OF COVERED DRUGS. How to use this list: On a high-deductible, health savings account (HSA)? Refer to the E1 formulary. For all covered drugs, once you have satisfied your medical deductible, you will pay your applicable coinsurance until you reach your out-of-pocket maximum for the plan year.