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Medications

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

Last updated: July 1, 2024

Plan Future Formulary Changes

Please check these formulary updates for upcoming changes in the drug coverage list.
Download PDF: June 2024
Last updated: June 3, 2024
Requirements and Policies

Step Therapy Requirements

Download PDF:
July 2024
Last updated: July 1, 2024

Prior Authorization Requirements

Download PDF:
July 2024
Last updated: July 1, 2024

Prescription Drug Transitional Care Policy

Download PDF: English Spanish Chinese
Last updated: June 7, 2023

Request for Medicare Prescription Coverage Determination Form

Download PDF: Determination Form
Last updated: May 9, 2024

Request for Medicare Prescription Coverage Redetermination Form

Download PDF: Redetermination Form
Last updated: May 9, 2024