Prescription Drug Benefits
Check below for important information about the Part D transition process, prior authorizations, the step therapy criteria for Part D Medicare, and the coverage determination and redetermination processes.
You can also find out more about getting Extra Help with your prescription drug coverage.
Prescription Drug Resources
Drug Formulary PDF
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Plan Formulary – November 2023: English/Spanish/Chinese
Plan Formulary – January 2024: English/Spanish/Chinese
Last updated: November 27, 2023
Future Formulary Changes
Please check these formulary updates for upcoming changes in the drug coverage list.
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October 2023
Last updated: September 28, 2023
Requirements and Policies
Step Therapy Requirements
Last updated: November 16, 2023
Prior Authorization Requirements
Last updated: November 16, 2023
Prescription Drug Transitional Care Policy
Request for Medicare Prescription Coverage Determination Form
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Determination Form
Last updated: March 31, 2023
Request for Medicare Prescription Coverage Redetermination Form
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Redetermination Form
Last updated: November 15, 2020