For a list of the most Common Drugs Requiring Preauthorization, please reference our Preferred Drug List.
For a complete list, please reference our Complete Formulary
These exclusions are in addition to those listed on the Complete Formulary above
Important Points to Remember:
- The printed version may not contain the most current formulary information
- Medications requiring prior authorization are shaded on the formulary
- Some over-the-counter drugs are covered by the drug plan
- Providers and pharmacies can contact the following number for prescription assistance: 844.825.9319.
For Updates and Assistance:
- If you need further assistance, please contact:
- Benefit coverage questions may be directed to Health Tradition Customer Service toll-free at 844.825.9319.
- Prior authorization questions may be directed to MedImpact at 888-728-5057.