Provider Info
Information for Physicians and Other Providers:
Find our Prior Auth forms for drugs here. Print a Coverage Determination Request form (237KB PDF) Find the Medicare Step Therapy requirements here. Find Provider Services contact numbers here. |
Search our approved drug list (formulary) for drugs that are approved for
prescription coverage under all our PriorityMedicareSM
plans.
Revised Drug Tiers for 2007 The Approved Drug Lists below tell you a drug's "tier" or cost level. For 2007, $0-copayment drugs (Loratadine, Loratadine-D, Prilosec OTC®) are no longer called "Tier 1." Therefore, generics are now Tier 1, preferred brand names are Tier 2, non-preferred brand names are Tier 3.
Limitations Some drugs listed as covered may have additional requirements or limits to their coverage, such as prior approval from the plan ("prior authorization") or trying other drugs first ("step therapy"). Contact us for more information about this. Find Your DrugsIndividually Purchased Plans If you purchase your own plan, use this approved drug list (formulary) for 2007: Section 1: Introduction and frequently asked questions (52KB PDF) Employer-Funded Retirement Plans Check your Evidence of Coverage booklet to see if you are covered by the 2006 or 2007 plan. If you're covered by a 2007 plan, use this approved drug list (formulary): Section 1: Introduction and frequently asked questions (214KB PDF) More Information
*Copayments for a 31-day supply before the out-of-pocket limit is reached. Costs may vary when your plan is provided by an employer. People on limited incomes may pay less for their drugs. Find out if you qualify. Acrobat Reader Software is required to view and print PDF files. Download it free now! H2320_4000_4006_59 F&U (01/07) S5857_4000_4006_59 F&U (01/07)
Last modified
12/03/07
|
