Formularies

A formulary is a list of covered drugs selected by MetroPlus which represents the prescription therapies believed to be a necessary part of a quality treatment program. MetroPlus will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a MetroPlus network pharmacy, and other plan rules are followed. Check your benefit materials for more specific information or call us if you have any questions. 

 

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Lines of Business Document Effective Date
Marketplace Plans (Individual)
Marketplace Plans (SHOP)
Essential Plan 
Formulary
STEP Criteria
August 2017
MetroPlus Gold Formulary
STEP Criteria
August 2017
MetroPlus GoldCare I & II Formulary
STEP Criteria
August 2017
Medicaid
Child Health Plus
Partnership In Care (SNP)
MetroPlus Enhanced (HARP)
Formulary
Quick Reference Guide
October 2017
Medicare 2017 Comprehensive Formulary
(English | Español | 中文)
Prior Authorization

STEP Criteria
Part B Diabetes Monitoring Device and Supply Policy
November 2017




July 2017
Medicare 2018 Comprehensive Formulary
(English | Español | 中文)

STEP Criteria
Prior Authorization
Part B Diabetes Monitoring Device and Supply Policy
January 2018
 

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MetroPlus FIDA Participant Comprehensive Formulary 2017
Updated 11/2017
 
English  Español  Italiano Русский Kreyòl Ayisyen 中文 한국어
Download Download Download Download Download Download Download
 

MetroPlus FIDA Participant Comprehensive Formulary 2018
Updated 10/2017
English / Español 
Download
 
FIDA 2017 Prior Authorization November 2017
FIDA 2017 STEP Criteria  January 2017
FIDA 2017 Part B Diabetes Monitoring Device and Supply Policy        January 2017
 
FIDA 2018 Prior Authorization  January 2018
FIDA 2018 STEP Criteria      January 2018
FIDA 2018 Part B Diabetes Monitoring Device and Supply Policy    January 2018
 

 

 

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