Formulary
A list of drugs covered by a plan.
Drugs are added to or removed from our Formulary during the year. Customers are notified at least 60 days before the effective change date.
Find a Drug
Click here to find a drug.
Comprehensive Formulary
Download Comprehensive Formulary (PDF file)
Prior Authorization Guidelines
Download Prior Authorization Guidelines
Quantity Limit Guidelines
Download Quantity Limit Guidelines
Step Therapy Guidelines
Download Step Therapy Guidelines
Note: You must have Adobe Reader version 5.0 or higher installed on your computer in order to view and print the above file properly. Click here to download a FREE COPY of Adobe Reader.
updated 10/1/10
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