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  • Availity® Essentials
  • Availity® Essentials
  • Home Providers Pharmacy

    Pharmacy resources

    Medicare Drug List Formulary Reference Guide

    Our formulary is a comprehensive list of drugs covered by our Medicare plans. Providers 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 for providers.

    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 page.

    For information on our Medicare Part B Step Therapy program, including preferred medication lists, refer to prior authorization.

    You can request prior authorization using any of the following:

    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.