Formulary

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Advantra 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.

2014 Formulary

Find 2014 Information

2015 Formulary

Formulary Change Notice
Advantra Gold (PPO) - H9847 (001)
Online Formulary Search
Obtain pricing and coverage information for any medications available through your plan
Printable Formulary
Advantra Gold (PPO) - H9847 (001)


Additional Information

Grievances & Appeals
Grievance & appeal information for Advantra 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: 09/28/2014
CMS Approved Date: Approved 02/08/2013
CMS Document ID: Y0022_PDPCCP_2013_4006_1202b

© Copyright 2008-2014 Coventry Health Care

Coventry Health Care is a Coordinated Care plan with a Medicare contract. First Health Part D is a Medicare-approved Part D sponsor. Enrollment in our plans depends on contract renewal.