Formulary

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Summit (HMO) & Advantra (HMO/HMO-POS) Plan 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.

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

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

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