Preferred Medication Lists
AvMed Commercial Formularies are updated quarterly.
Please choose the medication list option that applies to you.
Medicare Members
- Medicare 2020 Formulary Documents:
AvMed Medicare 2021 Comprehensive Formulary (Effective January 1, 2021)
AvMed Medicare 2021 Comprehensive Formulary (Spanish) (Effective January 1, 2021)
2021 Part D Prior Authorization Criteria (Effective January 1, 2021)
2021 Part D Step Therapy Criteria (Effective January 1, 2021)
Upcoming Changes to AvMed's Medicare Formulary (Effective November 1, 2020)
AvMed Medicare 2020 Comprehensive Formulary (Effective November 1, 2020)
AvMed Medicare 2020 Comprehensive Formulary (Spanish) (Effective November 1, 2020)
2020 Part D Prior Authorization Criteria (Effective November 1, 2020)
Upcoming Changes to AvMed's Medicare Formulary (Effective October 1, 2020)
AvMed Medicare 2020 Comprehensive Formulary (Effective October 1, 2020)
AvMed Medicare 2020 Comprehensive Formulary (Spanish) (Effective October 1, 2020)
2020 Part D Prior Authorization Criteria (Effective October 1, 2020)
2020 Part D Step Therapy Criteria (Effective March 1, 2020)
2021 Over-the-Counter Health Solutions Catalog (Effective January 1, 2021)
2020 Over-the-Counter Health Solutions Catalog
- Part D Transition Policy
- Part B Diabetic Policy
- AvMed's Authorization Requirements & Processes
- Explanation of Part D Appeals
- Medication Exception Request Form (Medicare)
- Medication Therapy Management (MTM) - SinfoniaRx Program:
MTM SinfoniaRx Provider FAQs (Spanish)
MTM SinfoniaRx Provider - Tracking Medications
MTM SinfoniaRx Provider - Why Adherence Matters
- PA Requirements - Office, Outpatient Facility, Home Health (Last Update July 2020)
Commercial Members
- 2021 Individual and Family Plan Formulary (Effective January 1, 2021)
- Medication Exception Request Form (Commercial)
- Diabetes Blood Glucose Meter Request
- Prescription Medication Quantity Limits
- Progressive Medication Program
- PA Requirements - Office, Outpatient Facility, Home Health (Last Update July 2020)
- Medication Prior Authorization (PA) Criteria (Last Update August 5, 2020)
- Medication Synchronization (Member)
- Medication Synchronization (Pharmacy)
- Member Opioid Fact Sheet
- Use the following 5-Tier Formulary if you have one of the following plans:
- Small Group Plans: Elect, Elite, Engage, Empower, Focus, Flex
- Large Group Plans: Achieve, Agility, Engage, Empower
- Individual & Family Plans: Engage, Empower
2020 5-Tier Commercial Formulary (Updated October 1, 2020)
- Use the following 4-Tier Formulary if you have one of the following plans:
- Small Group Plans: Achieve, Agility, Choice, HMO
- Large Group Plans: Choice, HMO, POS
2020 4-Tier Commercial Formulary (Updated October 1, 2020)
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AvMed Medicare is an HMO plan with a Medicare contract. Enrollment in AvMed Medicare depends on contract renewal.
Address: 9400 S. Dadeland Blvd. Miami, FL 33156
Prospective Members: 888-492-8633 (TTY 711)
Current Members: 800-782-8633 (TTY 711)
October 1–March 31, 8 am-8 pm, 7 days a week.
April 1–September 30, 8 am-8 pm, Monday-Friday.
H1016_AD832-092018. Last updated October 1, 2018.