Comprehensive Formulary

Use the links below to access the Senior Health Plan Comprehensive Formulary.

Abridged Formulary

Formulary Changes and Utilization Management Criteria

2020 Senior Health 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: 00020509 Version 5
HPMS Formulary Approval Date: 10/06/2019
Updated: 11/2019

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