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. 

New for MetroPlus members! Multiple medications pre-packaged for free. Available through PillPack or CVS Pharmacy. Learn more!
 

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Lines of Business Document Effective Date
Marketplace Plans (Individual)
Marketplace Plans (SHOP)
Essential Plan 
Formulary
STEP Criteria
 
June 2019
MetroPlus Gold Formulary
STEP Criteria
June 2019
MetroPlus GoldCare I & II Formulary 
STEP Criteria
June 2019 
Medicaid
Child Health Plus
Partnership In Care (SNP)
MetroPlus Enhanced (HARP)
Formulary 
Quick Reference Guide 
April 2019
Medicare  Comprehensive Formulary 
(English | Español | 中文)

STEP Criteria
Prior Authorization 
Part B Diabetes Monitoring Device and Supply Policy
June 2019
 

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