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Medicare Formulary Search
What is the Definition of a Formulary?
Our formulary is a preferred list of drugs selected to meet patient needs at a lower cost. ADVANTAGE Health Solutions, Inc. covers both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.
How to Search for a Drug using the Formulary Search Tool?
Alphabetical Search
  »   Select the letter below and the system will display an alphabetical listing of medications
  »   Use your keyboard or mouse to scroll through the list to find a medication

Drug Name Search
  »   Enter the drug name in the Drug Name box and click the <Search> button, or press <Enter>
  »   Use your keyboard or mouse to scroll through the list to find a medication

Therapy Category Search
  »   Use your mouse or the <Tab> key to select the Therapy Category box
  »   A listing of the available Therapy Categories will be displayed. Scroll within the box to select the therapy category you wish to view
  »   Highlight that entry and the list of medications in that Therapy Category will be displayed
  »   Use your keyboard or mouse to scroll through the list to find a medication

Therapy Class Search
  »   Use your mouse or the <Tab> key to select the Therapy Class box
  »   A listing of the available Therapy Classes will be displayed. Scroll within the box to select the Therapy Class you wish to view
  »   Highlight that entry and the list of medications in that Therapy Class will be displayed
  »   Use your keyboard or mouse to scroll through the list to find a medication
What do the Search Results Mean?
The drug search may list a single drug or a list of drugs. The search will tell you how the drug is covered in our plan; as well as other plan information you should know about the drug.

Tier Explanation
Each drug will indicate one of the following indicators.

Please Note: All drugs in both Tiers 1 and 2 are covered in the gap for our ADVANTAGE Select (PPO), ADVANTAGE Choice (PPO), ADVANTAGE Enhanced (PPO), ADVANTAGE Elite (PPO), ADVANTAGE Community Health Network (HMO), ADVANTAGE St. Francis Health Network (HMO), and ADVANTAGE Wishard Network (HMO) plans. Please refer to your Evidence of Coverage or Summary of Benefits for cost-sharing information on each tier level.

Indicator Description
1 Preferred Generic Drug
2 Non-Preferred Generic Drug
3 Preferred Brand Name Drug
4 Non-Preferred Brand Name Drug
5 Specialty Drug
NF Non-Formulary Drug. This drug is not on our plan formulary. If you click on “NF”, the system will display a listing of those agents which are similar in use, or function that are available as covered medications. This is not a complete list of all formulary alternatives covered by ADVANTAGE Health Solutions for the drug you have selected.

Note Explanation
Some drugs in your search results will have an indicator in the Notes section. Please refer to the table below to help explain what this indicator represents.

Indicator Description
PA Prior Authorization Required. If you click on “PA”, the system will display a popup window which will provide you further information regarding the prior authorization requirements.
SP Limited Access Drugs. This medication may only be available from certain pharmacies.
ST Step Therapy Required. If you click on “ST”, the system will display a popup window which will provide you further information regarding the step therapy requirements.
QL Quality Limit Restriction. If you click on the “QL”, the system will display a popup window which will provide you further information regarding the quality limit restriction.

Please Note: All formulary drugs are available via our mail-order.
What Changes are Made to the Formulary Throughout the Year?
We may make certain changes to our formulary during the year. Changes in the formulary may affect which drugs are covered and how much you will pay when filling your prescription. The kinds of formulary changes we may make include:
  »   Adding or removing drugs from the formulary
  »   Adding prior authorizations, quantity limits, and/or step-therapy restrictions on a drug

If you are a member of our plan and would like to request an exception for one of the following items, you can click here for information on how to contact us to:
  »   Cover a drug not on our formulary
  »   Change the tier level of a drug on our formulary
  »   Waive restrictions applied to a drug on our formulary