Approved Drug List for 2009 Plans

PriorityMedicare approved drug list

The approved drug (formulary) list tells you what prescription drugs are covered by our PriorityMedicare^SM plans. The drug list also includes each drug's tier or cost level.
Jump down the page to drug tier and prescription copay information.

Check the Approved Drug List

• Search our online Approved Drug List (formulary).
  Note: Clicking this link will take you away from this PriorityMedicare section of the Priority Health website.
• Print a copy of the list of approved drugs (192KB PDF)*.
  You'll find an index of drug names on page 42.
  For the most up-to-date information, please use the online approved drug list. A link appears below.
• Print a copy of the instructions for using the drug list and answers to frequently asked questions (52KB PDF)*.

More information about covered drugs

• View pending changes to the approved drug list.
• View a list of drugs not covered by Medicare plans.
• View special instructions on paying for vaccinations.
• Find out what to do if a drug you need isn't on the approved drug list or you'd like to request an exception to our approved drug list.
• Learn about Medicare step therapy requirements. Note: Clicking this link will take you out of the PriorityMedicare website.

Your doctor or other health care provider may need the following information.
Providers in our network have access to these forms on the priorityhealth.com website.

• Prior authorization forms for drugs
  Note: Clicking on this link will take you away from the PriorityMedicare site.
• Coverage Determination Request form (237KB PDF)*

*You'll need Adobe^® Reader software to view and print PDF files. Download it free now!

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Drug tiers for 2009

Tier	Drug Type	Drug copay for medical plans	Drug copAy for Rx Plan
1	Generics	$8	$7
2	Preferred brand-name	$30	$42
3	Non-preferred brand-name	$60	$65
4	Specialty	25% coinsurance	33% coinsurance

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 here.