Formulary Change Notices

Below is a list of changes that have occurred in the formulary, the list of covered drugs, since <Month Day, Year>.

Information includes:

  • drugs added or removed from the plan’s formulary
  • the addition of quality limits
  • step therapy or other restrictions on a drug
  • moving a drug to a higher cost-sharing tier


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A health plan with a Medicare contract.
H5884_W10_R2 CMS Approved 01042010
H7917_W10_R2 CMS Approved 01042010
A Medicare approved Part D sponsor.
S1030_W10_R2 CMS Approved 01042010

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