Formulary Information

Do you have Medicare Part D Prescription Drug Coverage through PrescribaRx^SM?

A formulary is a list of covered drugs selected by PrescribaRx in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. PrescribaRx will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy, and other plan rules are followed.

• You can search the formulary
• You can download and print the comprehensive formulary (see below)
• You can download and print an update to the comprehensive formulary (see below)

We may periodically add, remove or make changes to coverage limitations on certain drugs or change how much you pay for a drug. If we make any formulary change that limits our members’ ability to fill their prescriptions, we will notify the affected enrollees before the change is made. The Comprehensive and Abridged formularies were last updated in September 2009. Changes to our formulary are updated via a monthly supplemental addendum.

Need a hard copy of the PrescribaRx list of covered drugs?

• Download and print your PrescribaRx Abridged formulary.
• Download and print your PrescribaRx Comprehensive formulary.

Formulary Updates

• Signature Formulary - August 2010

Formulary Changes

• Signature Formulary - June 2010