The Navigator Resource Guide has not been updated for 2025 Open Enrollment. For more current information please visit:
cms.gov/marketplace/in-person-assisters/information-partners.
QUESTION

If I switch plans, how do I make sure the drug I am taking is covered under the new plan?

Individuals with coverage | Individual and Marketplace Health Coverage |
ANSWER

All Marketplace health insurers must make the formulary or list of covered drugs available to consumers on their websites. Consumers should be able to easily access a health plan’s formulary on an insurer’s website without creating an account or entering a policy number to access the information. In addition, the website link to the formulary should also be included in the Summary of Benefits and Coverage, which provides information on the covered benefits and applicable cost-sharing amounts, and on the Marketplace website. (45 C.F.R. § 147.200; 45 C.F.R. § 156.122).

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues