2012 Medicare Formulary
View the 2012 Medicare Formulary (list of covered drugs)
Notice of Medicare Formulary Change
Check here to see if there are any changes to the 2012 Medicare Formulary
2012 Drug Prior Authorization Requirements
Drug Prior Authorization Requirements
2012 Medicare Pharmacy Quantity Limits
Quantity Limit amounts and days for prescriptions for Medicare Members.
2012 Step Therapy Guidelines
Instructions for when we require you try certain drugs to treat a medical condition before we will cover another drug for that condition.
Medication Therapy Management
Services or programs that optimize therapeutic outcomes for individuals through improved medication use.
2012 Extra Help from Medicare
You might qualify to get help in paying for your drugs. “Extra Help” from Medicare, also called the “low-income subsidy” or LIS.
New York State’s EPIC Program
EPIC (Elderly Pharmaceutical Insurance Coverage) is a program offered by New York State that helps seniors pay for prescription drugs. EPIC can help lower Part D drug costs by helping pay for drugs in the coverage gap, as well as providing assistance with Part D premiums, if eligible.
2012 Transition Policy
Explanation of temporary coverage of certain drugs during the transition phase of a member’s benefit coverage.
Best Available Evidence
Review this information if you believe you may qualify for 'extra help' with your Medicare Prescription Drug Plan costs, but your plan's system and CMS's systems do not reflect your eligibility for this help. Find out how you may be able to obtain your prescriptions at the correct Low Income Subsidy (LIS) cost sharing level if you can show evidence of your LIS eligibility.
2012 Medicaid and Family Health Plus Formulary
Our list of covered drugs for Medicaid and Family Health Plus members