Preferred Medication Lists

AvMed Commercial Formularies are updated quarterly.

Please choose the medication list option that applies to you.

 

Medicare Members

• Medicare 2019 Formulary Documents:

AvMed Medicare 2019 Comprehensive Formulary (Effective January 1, 2019)

AvMed Medicare 2019 Comprehensive Formulary (Spanish) (Effective January 1, 2019)

2019 Part D Prior Authorization Criteria (Effective January 1, 2019)

2019 Part D Step Therapy Criteria (Effective January 1, 2019)

• Medicare 2018 Formulary Documents:

AvMed Medicare 2018 Comprehensive Formulary (Effective October 1, 2018)

AvMed Medicare 2018 Comprehensive Formulary (Spanish) (Effective October 1, 2018)

AvMed Medicare 2018 Negative Formulary Changes

2018 Part D Prior Authorization Criteria (Effective October 1, 2018)

2018 Part D Step Therapy Criteria (Effective October 1, 2018)

• 2017 Part D Transition Policy
• Part B Diabetic Policy
• AvMed's Authorization Requirements & Processes
• Explanation of Part D Appeals
• Medication Exception Request Form (Medicare)
• 2018 Medication Therapy Management (MTM)
• PA Requirements - Office, Outpatient Facility, Home Health (Last Update 08/23/2018)

Commercial Members

• Medication Exception Request Form (Commercial)
• Diabetes Blood Glucose Meter Request
• Prescription Medication Quantity Limits (2018)
• Progressive Medication Program
• PA Requirements - Office, Outpatient Facility, Home Health (Last Update 04/12/2018)
• Medication PA Criteria
  • Office, Outpatient Facility, Home Health
  • Pharmacy
• Medication Synchronization (Member)
• Medication Synchronization (Pharmacy)
• Member Opioid Fact Sheet

• Engage and Empower Members:

2018 5-Tier Commercial Formulary (Effective October 1, 2018)

Use the above 5-Tier Formulary if you have one of the following plans:

• Small Group Plans: Engage, Empower
• Large Group Plans: Engage, Empower, Achieve, Agility
• Individual & Family Plans: Engage, Empower
• Group and Individual Members/Employers:

2018 4-Tier Commercial Formulary (Effective October 1, 2018)

Use the above 4-Tier Formulary if you have one of the following plans:

• Small Group Plans: Achieve, Agility, HMO, Choice
• Large Group Plans: HMO, Choice, POS
• Individual & Family Plans: Easy, Elite

Note:

If your plan's prescription medication benefit includes the "Cost-sharing drugs" tier, please reference the 2018 4-Tier Commercial Formulary. The cost-sharing drug tier has been discontinued.

 

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.