Pharmacy Policies

These pharmacy policies apply to Medicare Advantage plans.

Certain medications may be covered under Medicare Part B. These are drugs that are usually not self-administered and are injected or infused in a doctor’s office, an outpatient hospital clinic, or outpatient infusion center. Some of these medications may require a prior authorization (PA). Visit the link below for a list of these Part B medications requiring PA.

The policies below are in PDF format. If you do not have Adobe Acrobat Reader, you may download it here.

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Archived Pharmacy Policies