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2026 Dual Premier (HMO D-SNP) Approved Drug List

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Medicare Dual Premier (HMO-D-SNP)

Page last updated on: 12/29/25

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2026 HIDE-SNP Approved Drug List
Machine-readable formulary

Some drugs may require your provider to fill out an authorization form.

PriorityMedicare® Dual Premier (HMO D-SNP) prior authorization criteria
Medicare Part D step therapy criteria
Request for Medicare Part D coverage determination
Medicare Part B vs Medicare Part D coverage determination form
Hospice coverage determination form

Drugs covered under the medical benefit

Medical Drug List (MDL)
Medicare Part B Prior Authorization and Step Therapy criteria
Medicare Part B drug request form (non-oncology)
Medicare Part B oncology drug request

Learn how to request a drug redetermination (appeal).

Drug Recalls and Market Withdrawals

Information on FDA drug recalls, market withdrawals, and safety alerts can be found here.

Electronic prior authorizations

Medical benefit drugs

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