Formulary
Advantra (HMO/PPO) Plan Formularies
A formulary is a list of medications that are covered by your plan.
Please see the below list to review your plan formulary. Or you can call us at the numbers listed on your member identification card.
2010 Formulary - Iowa & South Dakota
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Online Formulary Search - Iowa:
For Members Only
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Online Formulary Search - South Dakota
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Printable Formulary - Iowa & South Dakota
- Combined formulary for Advantra Silver (HMO), Advantra SW (HMO), Advantra Platinum PPO, Advantra Platinum PPO SW (PPO), and Advantra Platinum PPO SD (PPO)
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Formulary Change Notice - Iowa & South Dakota
- Formulary Change notice for Advantra Silver (HMO), Advantra SW (HMO), Advantra Platinum PPO, Advantra Platinum PPO SW (PPO) and Advantra Platinum PPO SD (PPO)
Other Information
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Grievances & Appeals
- Click here for more information
- Medicare Part D Prescription Drug Benefits
- Click here to find more information about Coventry's Part D benefits
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More Information
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Please use the links below to find more information about Coventry's Prescription Drug plans
- Prior Authorizations & Exceptions
- Transition Policies and Exceptions Process
- Out of Network Coverage
- Quality Assurance Policies and Procedures
- Potential For Contract Termination
