Use the links below to access the Senior Health Plan Comprehensive Formulary.
Extended Day Supply for Tier 1 and 2 drugs (100 days or more)
Enjoy the convenience of extended supplies on select medications (100 days or more) and pay $0 copay.
- Learn more about Extended Day Supply Drugs
- Extended Day Supply Drug List
- Large Print Extended Day Supply Drug List
Formulary Changes and Utilization Management Criteria
|Formulary Changes||Prior Authorization||Step Therapy||Quantity Limits|
|January||January 2020 Formulary Changes||January 2020 Prior Authorization Criteria - updated 11/27/2019||January 2020 Step Therapy Criteria - updated 11/4/2019||See comprehensive formulary for quantity limits.|
|February||February 2020 Formulary Changes||February 2020 Prior Authorization Criteria||February 2020 Step Therapy Criteria||See comprehensive formulary for quantity limits.|
|March||March 2020 Formulary Changes||March 2020 Prior Authorization Criteria||March 2020 Step Therapy Criteria||See comprehensive formulary for quantity limits.|
HPMS Formulary ID: 00020509 Version 7
HPMS Formulary Approval Date: 02/25/2020
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