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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2022 Plan Formulary – English/Spanish/Chinese
Last updated: 11/29/2022
Future Formulary Changes
Please check these formulary updates for upcoming changes in the drug coverage list.
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Plan Future Formulary Changes – Effective January 21, 2022
Plan Future Formulary Changes – Effective February 26, 2022
Plan Future Formulary Changes – Effective April 21, 2022
Plan Future Formulary Changes – Effective June 1, 2022
Plan Future Formulary Changes – Effective July 1, 2022
Plan Future Formulary Changes – Effective January 21, 2022
Plan Future Formulary Changes – Effective February 26, 2022
Plan Future Formulary Changes – Effective April 21, 2022
Plan Future Formulary Changes – Effective June 1, 2022
Plan Future Formulary Changes – Effective July 1, 2022
Last updated: 01/25/2022
Requirements and Policies
Step Therapy Requirements
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2022 Plan Step Therapy Requirements – July 2022
2022 Plan Step Therapy Requirements – July 2022
Last updated: 11/29/2022
Prior Authorization Requirements
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2022 Plan Prior Authorization Requirements – July 2022
2022 Plan Prior Authorization Requirements – July 2022
Last updated: 11/29/2022
Prescription Drug Transitional Care Policy
Request for Medicare Prescription Coverage Determination Form
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Determination Form
Last updated: 02/05/2021
Request for Medicare Prescription Coverage Redetermination Form
Download PDF:
Redetermination Form
Last updated: 11/15/2020