Use the links below to access the Advantage Medicare Plan Comprehensive Formulary.
Formulary Changes | Prior Authorization | Step Therapy | Quantity Limits | |
January | January 2021 Formulary Changes | January 2021 Prior Authorization Criteria - updated 12/23/2020 | January 2021 Step Therapy Criteria - updated 12/23/2020 | See comprehensive formulary for quantity limits. |
February | February 2021 Formulary Changes | February 2021 Prior Authorization Criteria | February 2021 Step Therapy Criteria | See comprehensive formulary for quantity limits. |
March | March 2021 Formulary Changes | March 2021 Prior Authorization Criteria | March 2021 Step Therapy Criteria | See comprehensive formulary for quantity limits. |
HPMS Formulary ID: 00021203 Version 9
HPMS Formulary Approval Date: 2/23/2021
Updated: 03/2021
Files will open in a new window and require Acrobat Reader to view.