First UA Medicare Part D

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

 

©1998-2012 First United American Life Insurance Company • All rights reserved • Y0063_12WFUA • CMS Approval Pending

Medicare Complaint Form: Click the link below to submit feedback about your prescription drug plan directly to Medicare:
https://www.medicare.gov/MedicareComplaintForm/home.aspx