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.

2012 Formulary Chance Notice

Advantra HMO and PPO Plans (PA)
Formulary Change Notice for Advantra Gold HMO, Advantra Silver HMO, Advantra Silver Plus HMO, Advantra Elite PPOP, Advantra Gold PPO, Advantra Silver PPO, and Advantra Silver Plus PPO plans in Pennsylvania.
Advantra PPO Plans (OH)
Formulary Change Notice for Advantra Elite PPO and Advantra Silver PPO plans in Ohio.


2012 Online Formulary Search

Advantra HMO and PPO Plans
Advantra HMO and PPO Plan Online Formulary Search


2012 Printable Formulary

Advantra HMO and PPO Plans
Printable Formulary for Advantra HMO and PPO plans in Central Pennsylvania, Western Pennsylvania and Eastern Ohio
Southeastern PA Gold PPO
Printable Formulary for Southeastern PA Gold PPO


Additional Information

Grievances & Appeals
Grievance & appeal information for 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: 12/23/2011
CMS Approved Date: 2/10/2012
CMS Document ID: Y0022_4006_711f

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