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)
Fomulary
Quick Reference Guide
July 2017
Medicare 2017 Comprehensive Formulary
(English | Español | 中文)

STEP Criteria
Prior Authorization
Part B Diabetes Monitoring Device and Supply Policy
July 2017
 

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MetroPlus FIDA Participant Comprehensive Formulary 
Updated 07/2017
 
English  Español  Italiano Русский Kreyòl Ayisyen 中文 한국어
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MetroPlus FIDA Prior Authorization 
MetroPlus FIDA STEP Criteria 
MetroPlus FIDA Part B Diabetes Monitoring Device and Supply Policy

 

 

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