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2026 Individual Medicare Approved Drug List

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Medicare Individual

Page last updated on: 12/29/25

Downloads

2026 Medicare Advantage Approved Drug List
Machine-readable formulary

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

2026 Medicare Part D prior authorization criteria
2026 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).

Electronic prior authorizations

Medical benefit drugs

Medicare Employer Group

Medicare Individual

Medicare MPSERS

Medicare Dual Premier (HMO-D-SNP)

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