Medication Formularies 2022
Medicare Formulary
Grandfathered Commercial Plans
Select Plan to view:
- 2022 Prescription Drug Formulary (PDF) | Drug Search | Prior Authorization Criteria
- Medical Pharmacy Formulary (PDF) | Drug Search| Prior Authorization Criteria
- FHCP $0 Drug List
Non-Grandfathered Commercial Plans
- 2022 Prescription Drug Formulary (PDF) | Drug Search | Prior Authorization Criteria
- Medical Pharmacy Formulary (PDF) | Drug Search| Prior Authorization Criteria
- FHCP $0 Drug List
Federal Exchange Plans
On/Off Marketplace Individual and Small Group ACA Compliant Plans.
- 2022 Prescription Drug Formulary (PDF) | Drug Search | Prior Authorization Criteria
- Medical Pharmacy Formulary (PDF) | Drug Search | Prior Authorization Criteria
- FHCP $0 Drug List
Prior Authorization Form
- FHCP Prior Authorization Medication Form (must be completed by physician)
Contraception Appliance Order Forms
- Last updated Aug 26, 2022