PHARMACY BENEFIT SERVICE

Plan A Only

Health Plan Preferred Medication List:

• Complete List (can be searched and printed)

• Quick List (can be printed)

Formulary Exceptions:

• Prior Authorization Process

• Prior Authorization Form

Additional medications available for Plan A only through the State of Michigan:

• Psychotropic, Substance Abuse and HIV/AIDS Medications

Plan B Only

Health Plan Preferred Medication List:

• Complete List (can be searched and printed)

• Quick List (can be printed)

Formulary Exceptions are not a Benefit for Plan B Members

Plan A and B

• Pharmacy Network Change - Effective July 2011

• Free Blood Glucose Meter Program

• Ascensia Glucometer Fax Order Form

• Other Medication Resources

• Medication Safety Tips

Provider Resources

Formulary Modification Request Form

Drug Recalls