Preferred Medication Lists
AvMed Commercial Formularies are updated quarterly.
Please choose the medication list option that applies to you.
Medicare Members
- Medicare 2021 Formulary Documents:
Upcoming Changes to Medicare Formulary (Effective March 1, 2021)
AvMed Medicare 2021 Comprehensive Formulary (Effective March 1, 2021)
AvMed Medicare 2021 Comprehensive Formulary (Spanish) (Effective March 1, 2021)
2021 Part D Prior Authorization Criteria (Effective March 1, 2021)
2021 Medicare Part B Step Therapy (Effective January 1, 2021)
2021 Part D Step Therapy Criteria (Effective January 1, 2021)
2021 Over-the-Counter Health Solutions Catalog (Effective January 1, 2021)
- 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 January 2021)
Commercial Members
- Medication Exception Request Form (Commercial)
- Diabetes Blood Glucose Meter Request
- Prescription Medication Quantity Limits
- Medical Preferred Drug List for Commercial Members (Effective January 1, 2021)
- Progressive Medication Program
- PA Requirements - Office, Outpatient Facility, Home Health (Last Update January 2021)
- Medication Prior Authorization (PA) Criteria (Last Update August 5, 2020)
- Medication Synchronization (Member)
- Medication Synchronization (Pharmacy)
- Member Opioid Fact Sheet
- Use the following 7-Tier Formulary if you have one of the following plans:
- Individual and Family Plan: Empower, Engage, Entrust
2021 7-Tier Individual and Family Formulary (Updated March 1, 2021)
- 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
2021 5-Tier Commercial Formulary (Updated January 1, 2021)
- 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
2021 4-Tier Commercial Formulary (Updated January 1, 2021)
Miami-Dade County Members
Jackson Health Members
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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.