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 – April 2024: English/Spanish/Chinese
Last updated: March 29, 2024
Future Formulary Changes
Please check these formulary updates for upcoming changes in the drug coverage list.
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April 2024
Last updated: March 29, 2024
Requirements and Policies
Step Therapy Requirements
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April 2024
Last updated: March 29, 2024
Prior Authorization Requirements
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April 2024
Last updated: March 29, 2024
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