Cigna Healthcare (now part of The Cigna Group, which also includes Express Scripts) uses Express Scripts as its pharmacy benefits manager. This integration means Cigna's formulary is managed by one of the largest PBMs in the country. Cigna offers multiple formulary options for employer plans, ranging from broad open formularies to more restrictive value formularies.

Key Facts

Express Scripts manages Cigna's pharmacy benefits, including formulary development and prior authorization
Cigna offers three main formulary types: Open, Performance, and Value (most restrictive)
Tier 1 preferred generics typically cost $0 to $10 per 30-day supply
Cigna's 2026 National Preferred Formulary added 150+ new medications from 2025 FDA approvals
Accredo is Cigna's specialty pharmacy for high-cost medications
90-day mail order through Express Scripts Pharmacy can save up to 40% on maintenance medications

Open Enrollment Reminder

ACA marketplace enrollment runs November 1 to January 15. Medicare Annual Enrollment is October 15 to December 7. Compare formularies for your medications before choosing a plan.

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Check Your Specific Plan's Formulary

Coverage varies by plan. Use our formulary checker tool to look up your exact copay and restrictions.

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Frequently Asked Questions

How do I check the Cigna formulary for my plan?

Visit mycigna.com and navigate to Coverage, then Prescription Medications. Enter your drug name to see tier placement, copay, and any restrictions. You can also use the Express Scripts app. Your specific formulary depends on your employer's chosen plan design.

What is the difference between Cigna's Open, Performance, and Value formularies?

The Open formulary covers the most drugs with fewer restrictions. The Performance formulary is moderately restrictive with preferred alternatives. The Value formulary is the most restrictive, covering fewer brand-name drugs and requiring more step therapy and prior authorizations, but offers the lowest premiums.

Does Cigna cover compounded medications?

Cigna's coverage of compounded medications is limited. Most plans require prior authorization for compounds, and many topical compounds are excluded. Coverage depends on your specific plan and whether the compound contains FDA-approved ingredients without commercially available alternatives.

Related Resources

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