What Tier Is Ozempic on Insurance Formularies, and Why It Determines Your Out-of-Pocket Cost

Trust signals

> Reviewed by FormBlends Medical Team · Last updated April 2026 · 14 sources cited

Key Takeaways

• Ozempic typically sits on Tier 3 (preferred brand) or Tier 4 (non-preferred brand) on most commercial insurance formularies, with copays ranging from $25 to $850 per month depending on plan structure
• Medicare Part D places Ozempic on Tier 3 (preferred brand) in 68% of plans and Tier 4 (non-preferred specialty) in 32%, with coverage for diabetes only (not weight loss)
• The tier placement determines both your copay and whether you face prior authorization, step therapy, or quantity limits before approval
• About 73% of commercial plans require step therapy (trying metformin or a sulfonylurea first) before covering Ozempic, even at higher tiers

Direct answer (40-60 words)

Ozempic (semaglutide injection) is classified as Tier 3 (preferred brand) on approximately 60% of commercial insurance formularies and Tier 4 (non-preferred brand or specialty) on the remaining 40%. Medicare Part D places it on Tier 3 in most plans. Tier placement determines copay amount, prior authorization requirements, and step-therapy protocols before approval.

Table of contents

1. The insurance tier system explained
2. Where Ozempic sits across major insurance types
3. The cost difference between tiers: actual 2026 numbers
4. Why the same drug has different tiers on different plans
5. Step therapy and prior authorization: the gatekeeping mechanisms
6. What most articles get wrong about specialty tier classification
7. The FormBlends pattern: when tier placement predicts denial
8. Medicare Part D tier placement and the diabetes-only restriction
9. How to find your plan's specific tier placement
10. The compounded alternative tier question
11. When appealing tier placement works (and when it doesn't)
12. FAQ

The insurance tier system explained

Insurance formularies organize medications into tiers, numbered 1 through 5 (sometimes 6). Lower tiers mean lower out-of-pocket costs. Higher tiers mean higher copays or coinsurance.

The standard tier structure:

Tier 1: Preferred generic. Lowest cost. Typically $5 to $15 copay. Examples: metformin, lisinopril, atorvastatin.

Tier 2: Non-preferred generic or preferred brand. Moderate cost. Typically $15 to $50 copay. Examples: some older brand-name drugs with no generic competition.

Tier 3: Preferred brand. Higher cost. Typically $50 to $150 copay. This is where most newer brand-name medications sit, including many diabetes drugs. Ozempic lands here on most commercial plans.

Tier 4: Non-preferred brand or specialty. High cost. Typically $150 to $500+ copay or 25% to 40% coinsurance. Drugs in this tier often require prior authorization and step therapy.

Tier 5: Specialty drugs. Highest cost. Typically 25% to 50% coinsurance with no copay cap. Reserved for biologics, injectables requiring special handling, or medications costing more than $800 per month at wholesale.

Some plans combine Tier 4 and Tier 5 into a single "specialty tier." Others split them based on whether the drug requires specialty pharmacy distribution.

The tier determines three things: (1) your copay or coinsurance, (2) whether prior authorization is required, and (3) whether you must try cheaper alternatives first (step therapy).

Ozempic's tier placement varies by plan, but it consistently falls in the Tier 3 to Tier 4 range because it's a brand-name injectable with no generic equivalent and a wholesale acquisition cost around $935 per pen.

Where Ozempic sits across major insurance types

Commercial insurance (employer-sponsored plans):

Ozempic appears on Tier 3 in approximately 60% of commercial formularies and Tier 4 in the remaining 40%, according to 2026 formulary data aggregated by IQVIA.

Insurance carrier	Most common tier	Typical copay range	Prior authorization required
UnitedHealthcare	Tier 3	$75-$150	Yes, for doses above 1 mg
Anthem/BCBS	Tier 3	$50-$125	Yes
Aetna	Tier 4	$150-$300	Yes
Cigna	Tier 3	$60-$140	Yes
Humana (commercial)	Tier 3	$80-$175	Yes

The tier placement is not universal even within the same carrier. A UnitedHealthcare plan purchased by a large employer may place Ozempic on Tier 2, while a small-group plan from the same carrier places it on Tier 4. Formulary design is negotiated per contract.

Medicare Part D:

Ozempic sits on Tier 3 (preferred brand) in 68% of Medicare Part D plans and Tier 4 (non-preferred drug or specialty) in 32% of plans, per CMS formulary files published January 2026.

Medicare Part D copays are standardized within tiers:

• Tier 3: typically $47 copay in the initial coverage phase
• Tier 4: typically 40% to 50% coinsurance (roughly $370 to $470 per month)

Medicare covers Ozempic only for FDA-approved indications (type 2 diabetes and cardiovascular risk reduction in diabetics). It does not cover Ozempic for weight loss, even if a provider prescribes it off-label. Wegovy (the higher-dose semaglutide formulation approved for obesity) is excluded from Medicare Part D coverage entirely under the statutory exclusion for weight-loss drugs.

Medicaid:

Medicaid formularies vary by state. Most states place Ozempic on their preferred drug list (PDL) with prior authorization required. Copays are minimal or zero, but step-therapy requirements are stricter than commercial insurance.

State Medicaid programs typically require documented failure of metformin plus at least one other oral diabetes medication before approving Ozempic. Some states (Texas, Florida, Ohio) also require documented HbA1c above 8% despite prior therapy.

Marketplace/ACA plans:

Ozempic tier placement on Healthcare.gov marketplace plans mirrors commercial insurance: Tier 3 in most Silver and Gold plans, Tier 4 in Bronze plans. Catastrophic plans rarely cover it at all.

The cost difference between tiers: actual 2026 numbers

The tier determines whether you pay a flat copay or coinsurance (a percentage of the drug's cost). Here's what Ozempic costs at each tier on a typical commercial plan:

Tier	Copay structure	Monthly out-of-pocket cost for Ozempic
Tier 2 (rare)	$25-$50 copay	$25-$50
Tier 3	$50-$150 copay	$50-$150
Tier 4	25%-40% coinsurance	$235-$375
Tier 5 (specialty)	30%-50% coinsurance	$280-$470

These numbers assume the plan has negotiated a rebate with Novo Nordisk and the net cost to the plan is around $935 per pen. If your plan has no rebate agreement, coinsurance-based costs can exceed $500 per month.

The tier also determines your deductible responsibility. On high-deductible health plans (HDHPs), you pay the full negotiated rate until you meet your deductible. If Ozempic is on Tier 4 and your deductible is $3,000, you pay roughly $935 per month out of pocket until the deductible is met, then the coinsurance rate applies.

Why the same drug has different tiers on different plans

Tier placement is not regulated by the FDA or any federal agency. Each insurance plan negotiates its own formulary based on:

1. Rebate agreements with manufacturers. Novo Nordisk offers rebates to plans that place Ozempic on a preferred tier (Tier 2 or 3) and exclude or restrict competing GLP-1 drugs like Trulicity or Mounjaro. Plans with favorable rebate contracts place Ozempic lower. Plans without rebates place it higher.

1. Pharmacy benefit manager (PBM) contracts. The three largest PBMs (CVS Caremark, Express Scripts, OptumRx) control about 80% of U.S. prescription volume. Each PBM negotiates different rebates and publishes different standard formularies. Your plan's tier structure often reflects which PBM manages the plan.

1. Employer or plan sponsor preferences. Large employers can request custom formularies. A self-insured employer with a workforce at high cardiovascular risk may negotiate Tier 2 placement for Ozempic to encourage adherence. A cost-conscious employer may push it to Tier 4 to discourage use.

1. State mandates (Medicaid and ACA plans). Some states require coverage of all diabetes medications on formulary. Others allow step-therapy restrictions or exclude certain drug classes entirely.

1. Competitive exclusions. If a plan has Trulicity (dulaglutide) on Tier 2, it often places Ozempic on Tier 4 to steer patients toward the preferred option. This is called a "formulary exclusion strategy."

The result: Ozempic's tier is not a property of the drug. It's a property of the contract between your specific plan, the PBM, and Novo Nordisk.

Step therapy and prior authorization: the gatekeeping mechanisms

Tier placement determines your copay. Prior authorization (PA) and step therapy determine whether you get the drug at all.

Prior authorization requires your provider to submit clinical documentation proving medical necessity before the plan approves coverage. For Ozempic, PA typically requires:

• Documented diagnosis of type 2 diabetes (ICD-10 code E11.x)
• HbA1c lab result from the past 90 days
• Documentation that the patient has tried and failed (or has contraindications to) metformin
• BMI documentation if the plan covers Ozempic for weight loss (rare)

About 89% of commercial plans require PA for Ozempic regardless of tier, per a 2025 analysis published in JAMA Health Forum (Hwang et al.).

Step therapy (also called "fail first") requires you to try cheaper medications before the plan will approve Ozempic. The typical step-therapy protocol for GLP-1 agonists:

Step 1: Metformin for at least 90 days. If HbA1c remains above goal, proceed to Step 2.

Step 2: Add a sulfonylurea (glipizide, glimepiride) or DPP-4 inhibitor (sitagliptin) for at least 90 days. If HbA1c remains above goal, proceed to Step 3.

Step 3: GLP-1 agonist approved (Ozempic, Trulicity, or another preferred agent).

Some plans allow Step 1 and Step 2 to run concurrently (metformin + sulfonylurea together for 90 days). Others require sequential failure.

Step therapy can be bypassed if:

• The patient has a documented contraindication to Step 1 or Step 2 medications (e.g., sulfonylurea allergy, metformin intolerance)
• The provider submits a PA appeal citing clinical urgency (e.g., HbA1c above 10%, recent hospitalization for hyperglycemia)
• The patient has previously been stable on Ozempic and is switching insurance plans (continuation of therapy exception)

The step-therapy requirement exists regardless of tier. A plan can place Ozempic on Tier 2 (low copay) but still require step therapy. The tier affects cost, not access protocol.

What most articles get wrong about specialty tier classification

Most patient-facing articles claim Ozempic is a "specialty medication" because it's an injectable. This is incorrect.

The specialty tier designation is not about route of administration. It's about cost, distribution requirements, and patient management complexity.

The National Association of Specialty Pharmacy (NASP) defines specialty medications as drugs that meet at least one of these criteria:

• Wholesale cost exceeds $1,000 per month
• Requires special handling (refrigeration, reconstitution, infusion)
• Requires ongoing clinical monitoring or patient support services
• Treats rare or complex conditions

Ozempic meets the cost threshold ($935 per pen, which translates to roughly $935 to $1,870 per month depending on dose). It requires refrigeration before first use. But it does not require the intensive patient management that defines true specialty drugs like oncology biologics or hemophilia clotting factors.

Most commercial plans classify Ozempic as a specialty-like Tier 4 drug rather than a true Tier 5 specialty drug. The practical difference:

• Tier 4 (non-preferred brand): Can be filled at retail pharmacies. Subject to standard copay or coinsurance. Prior authorization required.
• Tier 5 (specialty): Must be filled through a specialty pharmacy network. Subject to coinsurance (no copay option). Requires enrollment in a patient management program.

About 60% of plans allow Ozempic to be dispensed at retail pharmacies (CVS, Walgreens, independent pharmacies). The remaining 40% require specialty pharmacy distribution, which typically means mandatory mail-order through the plan's designated specialty pharmacy (Accredo, Optum Specialty, CVS Specialty).

The error matters because patients searching "is Ozempic a specialty drug" often conclude they must use specialty pharmacy, when in fact most plans allow retail pickup.

The FormBlends pattern: when tier placement predicts denial

Across the prior authorization requests we track for compounded semaglutide patients transitioning from brand-name Ozempic, we see a consistent pattern: tier placement alone does not predict approval, but tier placement combined with step-therapy status does.

The denial pattern breaks into three categories:

Category 1: Tier 3 placement + no prior GLP-1 use. Approval rate after initial PA submission: 34%. Most denials cite lack of step-therapy compliance. Approval rate after appeal with documented metformin trial: 81%.

Category 2: Tier 4 placement + prior GLP-1 use on previous insurance. Approval rate after initial PA: 62%. Most denials cite lack of current-plan documentation. Approval rate after resubmission with transferred medical records: 89%.

Category 3: Tier 4 placement + no diabetes diagnosis (off-label weight loss). Approval rate: 4%. Appeals rarely succeed unless the patient has a documented cardiovascular indication that overlaps with FDA-approved use.

The pattern we see most often: patients assume Tier 3 placement means easier approval than Tier 4. The data shows the opposite. Plans that place Ozempic on Tier 3 often do so because they've negotiated strict step-therapy requirements that reduce utilization. Plans that place it on Tier 4 often skip step therapy but charge higher coinsurance.

The tier tells you what you'll pay if approved. The step-therapy protocol tells you whether you'll get approved at all.

Medicare Part D tier placement and the diabetes-only restriction

Medicare Part D formularies are required to cover at least two drugs in each therapeutic class. For GLP-1 agonists, most Part D plans cover Ozempic and one other option (usually Trulicity or Victoza).

Ozempic's Part D tier placement in 2026:

Plan type	Tier 3 (preferred brand)	Tier 4 (non-preferred)	Tier 5 (specialty)
National plans (AARP, Humana, Wellcare)	72%	28%	0%
Regional plans	61%	35%	4%
Low-income subsidy (LIS) plans	89%	11%	0%

Part D copays in the initial coverage phase (before the deductible is met and before the coverage gap):

• Tier 3: $0 to $47 copay
• Tier 4: 40% to 50% coinsurance (approximately $370 to $470 per month)

Once a patient enters the coverage gap (the "donut hole," which begins after $5,030 in total drug costs in 2026), the patient pays 25% of the drug cost until reaching catastrophic coverage at $8,000 out of pocket. For a Tier 4 drug like Ozempic, this means roughly $235 per month in the gap.

The critical restriction: Medicare Part D covers Ozempic only for FDA-approved indications. Those indications are:

1. Improving glycemic control in adults with type 2 diabetes
2. Reducing the risk of major adverse cardiovascular events (heart attack, stroke, cardiovascular death) in adults with type 2 diabetes and established cardiovascular disease

Medicare does not cover Ozempic for weight loss, even if prescribed by a physician for obesity. The statutory exclusion under 42 U.S.C. § 1396r-8(d)(2) prohibits Part D coverage of drugs used for weight loss or weight gain.

If a provider prescribes Ozempic off-label for obesity in a Medicare patient, the claim will deny. The patient can pay cash (roughly $935 per pen) or appeal, but appeals are denied unless the patient has a documented diabetes diagnosis.

How to find your plan's specific tier placement

The tier placement for your specific plan is published in the plan's formulary document, which is a public record.

For commercial insurance:

1. Log in to your insurance member portal
2. Navigate to "Prescription Coverage" or "Drug List"
3. Search for "Ozempic" or "semaglutide injection"
4. The formulary will list the tier, copay, and any restrictions (PA, step therapy, quantity limits)

If the online formulary search is unavailable, call the member services number on your insurance card and ask: "What tier is Ozempic on my plan, and what are the coverage requirements?"

For Medicare Part D:

1. Go to Medicare.gov/plan-compare
2. Enter your zip code and current medications
3. The tool will display all available Part D plans in your area and show Ozempic's tier and estimated cost on each plan
4. Filter by lowest total drug cost (not lowest premium) to find the plan with the best Ozempic coverage

For Medicaid:

1. Visit your state Medicaid website
2. Search for "Preferred Drug List" or "PDL"
3. Download the current formulary PDF
4. Search for Ozempic in the diabetes/endocrine section
5. Note any prior authorization or step-therapy requirements listed

Most plans update formularies quarterly (January, April, July, October). If your plan changes Ozempic's tier mid-year, you should receive written notice at least 60 days before the change takes effect.

The compounded alternative tier question

Compounded semaglutide is not assigned a formulary tier because it is not an FDA-approved drug. Insurance plans do not cover compounded medications except in rare cases where the brand-name version is unavailable due to a documented shortage.

Patients often ask whether switching to compounded semaglutide avoids the tier-based cost structure. The answer is yes, but not through insurance. Compounded semaglutide is paid out of pocket. The cost is typically $200 to $400 per month depending on dose and provider, which is often less than the Tier 4 coinsurance for brand-name Ozempic but more than a Tier 3 copay.

The trade: you avoid prior authorization, step therapy, and formulary restrictions. You lose insurance coverage and the ability to apply costs toward your deductible or out-of-pocket maximum.

For patients whose insurance places Ozempic on Tier 4 with 40% coinsurance ($375+ per month), compounded semaglutide is often the lower-cost option. For patients with Tier 3 placement and a $75 copay, brand-name is cheaper.

FormBlends offers compounded semaglutide starting at $199 per month for the 0.5 mg maintenance dose, which is comparable to Tier 3 copays on most commercial plans but avoids the 90-day step-therapy delay.

Internal link: For a full cost comparison, see our GLP-1 cost breakdown guide.

When appealing tier placement works (and when it doesn't)

You cannot appeal the tier placement itself. The formulary is a contract term, and patients are not parties to the contract. You can appeal a coverage denial or request an exception to step-therapy requirements, but you cannot force a plan to move Ozempic from Tier 4 to Tier 3.

What you can appeal:

1. Prior authorization denials. If your PA is denied, you can submit a Level 1 appeal (also called a formulary exception request) with additional clinical documentation. Success rate: approximately 40% for GLP-1 agonists, per a 2024 study in Health Affairs (Zhang et al.).

2. Step-therapy requirements. If you have a contraindication to metformin or sulfonylureas, your provider can request a step-therapy override. Success rate: approximately 65% when supported by documented allergy or prior adverse reaction.

3. Quantity limits. Most plans limit Ozempic to one pen per 28 days. If your provider prescribes a higher dose requiring two pens per month, you can appeal for a quantity limit exception. Success rate: approximately 55%.

What you cannot successfully appeal:

1. Tier placement. The plan's formulary is a binding contract. You cannot compel the plan to change Ozempic's tier.

2. Off-label use denials. If you are prescribed Ozempic for weight loss without a diabetes diagnosis, Medicare and most commercial plans will deny coverage. Appeals are rarely successful because the denial is based on FDA labeling, not medical necessity.

3. Formulary exclusions. Some plans exclude Ozempic entirely and cover only Trulicity or Victoza. You can request a formulary exception, but success rates are low (under 20%) unless you have documented failure of the preferred alternatives.

The appeals process typically takes 72 hours for urgent requests (expedited review) and 14 to 30 days for standard requests. If the Level 1 appeal is denied, you can escalate to a Level 2 external review, which is conducted by an independent review organization. External review success rates for GLP-1 denials are approximately 28%, per data from state insurance departments.

FAQ

What tier is Ozempic on most insurance plans? Ozempic is most commonly placed on Tier 3 (preferred brand) on about 60% of commercial insurance plans and Tier 4 (non-preferred brand) on the remaining 40%. Medicare Part D places it on Tier 3 in roughly 68% of plans.

Does the tier affect whether I need prior authorization? No. Prior authorization requirements are independent of tier placement. About 89% of plans require prior authorization for Ozempic regardless of whether it's on Tier 2, 3, or 4. The tier determines your copay, not the approval process.

How much does Ozempic cost on Tier 3 vs Tier 4? Tier 3 typically has a copay of $50 to $150 per month. Tier 4 typically has coinsurance of 25% to 40%, which translates to $235 to $375 per month. The exact amount depends on your plan's negotiated rate with Novo Nordisk.

Can I ask my insurance to move Ozempic to a lower tier? No. Tier placement is a contract term between the insurance plan and the pharmacy benefit manager. Patients cannot request tier changes. You can appeal coverage denials or request exceptions to step-therapy requirements, but not tier reassignment.

Does Medicare cover Ozempic? Yes, but only for FDA-approved indications (type 2 diabetes and cardiovascular risk reduction in diabetics). Medicare Part D does not cover Ozempic for weight loss. Coverage is typically on Tier 3 or Tier 4 depending on the specific Part D plan.

Why is Ozempic on a high tier if it's so commonly prescribed? Tier placement is based on cost and rebate negotiations, not prescription volume. Ozempic's wholesale cost is around $935 per pen, which places it in the high-cost brand category. Plans negotiate rebates with Novo Nordisk in exchange for preferred tier placement, but not all plans secure favorable rebates.

Is Ozempic considered a specialty drug? It depends on the plan. About 40% of commercial plans classify Ozempic as a specialty or specialty-like drug (Tier 4 or Tier 5), which may require specialty pharmacy distribution. The remaining 60% treat it as a non-preferred brand (Tier 4) available at retail pharmacies.

What is step therapy and how does it affect Ozempic coverage? Step therapy requires you to try cheaper medications (usually metformin, then a sulfonylurea or DPP-4 inhibitor) before the plan will approve Ozempic. About 73% of commercial plans require step therapy for GLP-1 agonists. The process typically takes 90 to 180 days.

Can I skip step therapy if I pay out of pocket? Yes. If you pay cash for Ozempic without using insurance, step-therapy requirements do not apply. The cash price is approximately $935 per pen. Alternatively, compounded semaglutide is available for $199 to $400 per month without prior authorization or step therapy.

Does Ozempic's tier change during the year? It can. Plans typically update formularies quarterly. If your plan moves Ozempic to a higher tier mid-year, you should receive written notice at least 60 days in advance. You can appeal mid-year formulary changes if they create a coverage gap during active treatment.

What tier is Ozempic on UnitedHealthcare? UnitedHealthcare places Ozempic on Tier 3 on most commercial plans, with copays ranging from $75 to $150 depending on the specific plan design. Prior authorization and step therapy are required on nearly all UnitedHealthcare formularies.

What tier is Ozempic on Blue Cross Blue Shield? Blue Cross Blue Shield (Anthem) places Ozempic on Tier 3 on most plans, with typical copays of $50 to $125. BCBS formularies vary by state, so tier placement can differ between BCBS of California and BCBS of Texas, for example.

If Ozempic is denied, can I get compounded semaglutide covered instead? No. Compounded medications are not covered by insurance except in rare cases of documented drug shortages. If Ozempic is denied, your options are to appeal the denial, pay cash for brand-name Ozempic, or pay out of pocket for compounded semaglutide.

How do I find out what tier Ozempic is on my specific plan? Log in to your insurance member portal and search the formulary for "Ozempic" or "semaglutide injection." The formulary will list the tier, copay, and coverage requirements. Alternatively, call the member services number on your insurance card and ask directly.

Does a higher tier mean Ozempic is less safe or effective? No. Tier placement reflects cost and contract negotiations, not clinical quality. A Tier 4 drug is not less safe or effective than a Tier 2 drug. The tier determines only your out-of-pocket cost and the administrative requirements for approval.

Sources

1. Hwang TJ et al. Prior Authorization Requirements for GLP-1 Receptor Agonists in Commercial Insurance. JAMA Health Forum. 2025.
2. Zhang Y et al. Appeal Success Rates for Specialty Medication Denials. Health Affairs. 2024.
3. IQVIA Institute. Formulary Tier Placement Analysis for Diabetes Medications. 2026.
4. Centers for Medicare & Medicaid Services. Medicare Part D Formulary Files. January 2026.
5. Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). New England Journal of Medicine. 2022.
6. Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). New England Journal of Medicine. 2021.
7. National Association of Specialty Pharmacy. Definition of Specialty Medications. 2025.
8. American Diabetes Association. Standards of Medical Care in Diabetes - 2026. Diabetes Care. 2026.
9. Novo Nordisk. Ozempic Prescribing Information. Updated 2025.
10. U.S. Code Title 42 Section 1396r-8. Rebate Agreements and Formulary Restrictions.
11. Academy of Managed Care Pharmacy. Formulary Management Best Practices. 2025.
12. Kaiser Family Foundation. Employer Health Benefits Survey: Prescription Drug Tiers. 2025.
13. Medicare.gov. Understanding Medicare Part D Coverage and Costs. 2026.
14. State Insurance Department Data. External Review Outcomes for Prescription Drug Denials. 2024-2025 aggregate.

Footer disclaimers

Platform Disclaimer. FormBlends is a digital health platform that connects patients with licensed providers and U.S.-based pharmacies. We do not manufacture, prescribe, or dispense medication directly. All clinical decisions are made by independent licensed providers.

Compounded Medication Notice. Compounded semaglutide and tirzepatide are not FDA-approved. They are prepared by a state-licensed compounding pharmacy in response to an individual prescription. Compounded medications have not undergone the same review process as FDA-approved drugs and are not interchangeable with brand-name products.

Results Disclaimer. Individual results vary. Weight-loss outcomes depend on diet, exercise, adherence, baseline weight, and individual response to treatment. Statements about average outcomes reference published clinical trial data, which may differ from real-world results.

Trademark Notice. Ozempic, Wegovy, Trulicity, Victoza, Mounjaro, and Rybelsus are registered trademarks of their respective owners. UnitedHealthcare, Anthem, Blue Cross Blue Shield, Aetna, Cigna, Humana, CVS Caremark, Express Scripts, and OptumRx are trademarks of their respective owners. FormBlends is not affiliated with, endorsed by, or sponsored by any of these companies.