Pharmacy resources
Medicare Drug List Formulary Reference Guide
Our formulary is a comprehensive lists of drugs covered by our Medicare plans. Doctors and pharmacists select these drugs for their effectiveness, safety, ease of use and cost.
Resource for you: See our 2026 Medicare Advantage Standard 5 Tier Formulary Reference Guide [PDF] for providers.
Medicare Part B Step Therapy Program
Step therapy is a required process that applies to certain Part B prescription drugs. It requires members to first try a preferred medication over nonpreferred medications that treat the same condition.
Resource for you: See our information for providers on step therapy [PDF], including preferred medication lists.
Pharmacy prior authorization requests
We require prior authorization for some medications in order to optimize patient outcomes and ensure cost-effective care for members. See our prior authorization requirements.
You can request prior authorization using any of the following:
- Submit electronically (preferred method)
- Submit the appropriate prior authorization drug form
- Call
- Fax
Pharmacy networks
We contract with major retail pharmacy chains, grocery store chains, independent pharmacies and with Express Scripts Pharmacy for preferred home delivery, with other options for standard mail. Using pharmacies in our network can help your patients save money and improve medication adherence. See our pharmacy directory.
Accredo® Specialty Pharmacy, part of Evernorth® Health Services, is the preferred specialty pharmacy for HealthSpring. Call 1-844-516-3319.