A Healthy CollaborationSM

Tools for Part C Plans: Drug Search

Formulary Information

You may find using the Searchable Formulary for drug coverage and restrictions to be easier. To search for a drug in our formulary, select the plan you are enrolled in, and then enter the first three letters of the name of the drug or the complete name.

Search results will provide you detailed information about the drug, including:

  • Which tier the drug is in,
  • Whether there is a quantity limit (QL) for that particular drug,
  • If there is a lower cost-alternative drug available,
  • And if Prior Authorization (PA) from the plan is required before receiving the drug,
  • And if the drug requires a step therapy (ST) routine, those required drugs are listed.

The plan covers both brand name and generic drugs. Generic drugs have the same active ingredient formula as brand name drugs. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.

Search now or download the

Abridged Formulary
Comprehensive Formulary

Formularies are updated on a monthly basis and can change during the year. The formularies were last updated on 09/01/08.

Formulary Addendums

Formulary Changes

What is an Exception?
A member can request an exception to our formulary if we will not provide or pay for a Part D prescription drug that a member’s doctor has prescribed because it is not on our list of covered drugs (called a “formulary”). Or, if the member disagrees with the amount that we require to pay for a Part D prescription drug a member’s doctor has prescribed, a member can request an exception to the co-payment we require to pay for a drug.

What is a Prior Authorization?
TexanPlus® requires you to get prior authorization for certain drugs. This means that you will need to get approval from TexanPlus® before you fill your prescription. If you don’t get approval, TexanPlus® may not cover the drug.

This page will allow you to print Exception and Prior Authorization forms. You will also find these forms listed.

  • Prior Authorization Request
  • Quantity Limit Exception
  • Request for Coverage of a Non-Formulary Drug
  • Tiering Exception

M0018_H5656_webr6_1209 Pending CMS Approval Last updated: 1/11/2021

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