Formulary

ArchCare Advantage uses a formulary, which is a list of drugs covered by the plan. We may periodically add, remove or make changes to coverage limitations on certain drugs, or change how much you have to pay for a drug. If we make any formulary change that limits members' ability to fill their prescriptions, we will notify those affected before the change is made. Upon request, we will send a formulary to you, or you can download a copy here.

INFORMATION ABOUT BLOOD GLUCOSE TESTING SUPPLIES AT THE PHARMACY

• Blood Glucose Testing Supplies and Continuous Blood Glucose Devices

2022 FORMULARY

• Comprehensive Formulary – English
• Comprehensive Formulary – Spanish
• Prior Authorization Criteria
• Step Therapy Criteria

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