Comprehensive Formulary

Use the links below to access the Comprehensive Formulary.


Abridged Formulary


Formulary Changes and Utilization Management Criteria

2020 CommunityCare Prescription Drug Plan Utilization Management Criteria Documents
  Formulary Changes Prior Authorization Step Therapy Quantity Limits
JanuaryJanuary 2020 Formulary ChangesJanuary 2020 Prior Authorization Criteria - updated 11/27/2019January 2020 Step Therapy Criteria - updated 11/4/2019See comprehensive formulary for quantity limits.

HPMS Formulary ID: 00020511 Version 6
HPMS Formulary Approval Date: 10/06/2019
Updated: 11/2019

Files will open in a new window and require Acrobat Reader to view.