Formulary

Learn which medications require authorization.

Individual Members

• Commercial Formulary
   
  2010 Commercial Formulary
  (revised: 7/30/2010 9:16:42 AM)
  

Group Members

• Commercial Formulary
   
  2010 Commercial Formulary
  (revised: 7/30/2010 9:16:42 AM)
  
• 2010 Pocket Formulary 
• AvMed's Authorization Requirements & Processes 
• Commercial Rx Mail Order Form 
• Commercial Rx Health and Allergy Questionnaire
• 2-Tier Preferred Medication List
   
  2010 2-Tier Preferred Medication List
  (revised: 8/24/2010 3:10:09 PM)
  

Medicare Members

• AvMed Medicare 2010 Comprehensive Formulary
• AvMed's Authorization Requirements & Processes 
• Part D Prior Authorization Criteria
• Part D Step Therapy Criteria
• Part D Quantity Limit Information
• Explanation of Part D Appeals
• Medicare Rx Mail Order Form   
• Medicare Rx Health Allergy Questionnaire
• Medication Exception Request Form
• Quality Assurance: Drug Management Programs 

AvMed has contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in Miami-Dade and Broward counties.

If you qualify for extra help with your Medicare prescription drug coverage costs, Medicare may cover all or some portion of your prescription drug costs.  In certain cases, CMS systems do not reflect a beneficiary's correct low-income subsidy (LIS) status at a particular point.  To address these situations, CMS has created the best available evidence (BAE) policy that requires plans to accept appropriate documentation as evidence of establishing the accurate level of cost sharing the member should be paying.  Please use the link provided to learn more about this policy.