Formulary

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Advantra (PPO) 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 number listed on your member identification card.

2010 Advantra (PPO) Formulary

Online Formulary Search: For Members Only
Printable Formulary
  • Advantra Gold (PPO) and Advantra Platinum (PPO) Printable Formulary
Formulary Change Notice
Combined Advantra Gold (PPO) and Advantra Platinum (PPO) Formulary Change Notice


Additional Information

Grievances & Appeals
Grievance & appeal information for Advantra (PPO) members

Medicare Part D Prescription Drug Benefits
Click here to find more information about Coventry's Part D benefits.

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Page Last Updated: 08/31/2010
CMS Approved Date: Pending CMS Approval
CMS Document ID: Y0022_4006_711a

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