Prescription drug formulary and other plan documents
The Plan Documents search tool can help make it easier to find documents for a specific plan, like a plan's provider directory, drug list (formulary) or Evidence of Coverage.
If you've created a profile with us, you can also view documents for plans you’ve saved by logging into your profile and clicking on the name of one of your saved plans. Scroll down to the "Plan Documents" section to find the plan information you need.
Some medications require additional information from the prescriber (for example, your primary care physician). The forms below cover requests for exceptions, prior authorizations and appeals.
To learn about what can cause automatic disenrollment from a Medicare Part C or Part D plan or to request disenrollment from your current plan to switch to Original Medicare only, please visit the Disenrollment Information page.
Declaration of Disaster or Emergency
If you're affected by a disaster or emergency declaration by the President or a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.
Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
Where applicable, requirements for gatekeeper referrals are waived in full;
Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.
If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.
