Formulary

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Formulary

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 number listed on your member identification card. 

2016 Formulary

Formulary Change Notice
This is where you will find any changes to your covered drugs. See the Printed Formulary section below to find your formulary document for your plan.
Online Formulary Search
Obtain pricing and coverage information for any medications available through your plan
Printable Formulary
Advantra Gold (PPO) - H1608 (025)


Additional Information

Grievances & Appeals
Grievance & appeal information for members

Medicare Part D Prescription Drug Benefits

Find more information about Coventry's Part D benefits.

For mail-order, you can get prescription drugs shipped to your home through the network mail-order delivery program. Typically, mail-order drugs arrive within 7 to 14 days. Please call us if you do not receive your mail-order drugs within this timeframe.

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More Information

Y0022_PDPCCP_2013_4006_1202b Approved
CMS Approved Date: 02/08/2013
Page Last Updated: 03/09/2016

© Copyright 2008-2016 Coventry Health Care

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.