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.

2014 Formulary

Formulary Change Notice

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



Online Formulary Search

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


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 HMO and PPO Plans
Printable Formulary for Advantra Gold PPO and Advantra Silver HMO in Southeastern PA
Advantra Cares HMO SNP
Printable Formulary for Advantra Cares plan in Pennsylvania.


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: 03/28/2014
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.