Provider Information
- 2020 Provider Manual
- Participating Providers
- Participating Pharmacies
- Model of Care Training and Attestation
- Provider Quick Reference Guide
Medical Information and Authorization
Pharmacy Information and Authorization
Formulary 2020
- 2020 Comprehensive Formulary (Prescription Drugs)
(Last Updated 12/1/2020) - 2020 Comprehensive Formulary (Prescription Drugs), Spanish
(Last Updated 3/1/2020) - 2020 Formulary (Prescription Drugs) Changes
(Last Updated 12/1/2020) - 2020 Prior Authorization Criteria
(Last Updated 12/1/2020) - 2020 Step Therapy Criteria
(Last Updated 12/1/2020) - 2020 Quantity Limits
(Last Updated 12/1/2020) - 2020 Formulary (Prescription Drugs) Search Tool
- Online Part D Coverage Determination/Redetermination
Member Benefit Information
- 2020 Summary of Benefits
(contains multi-language insert) - 2020 Summary of Benefits (Spanish)