Provider Information
- 2026 Provider Manual
- Participating Providers
- Participating Pharmacies
- Model of Care Training and Attestation
- 2026 Provider Quick Reference Guide
- Provider Information Update
- Provider EFT/ERA Enrollment Form
Medical Information and Authorization
Pharmacy Information and Authorization
Formulary 2026
- 2026 Formulary (List of Covered Drugs)
(last updated 10/1/2025) - 2026 Formulary (List of Covered Drugs) (Spanish)
(last updated 10/1/2025) - 2026 Prior Authorization Criteria
(last updated 10/1/2025) - 2026 Step Therapy Criteria
(last updated 10/1/2025) - 2026 Formulary (Prescription Drugs) Search Tool
- Online Part D Coverage Determination/Redetermination
- 2026 Provider Coverage Determination Form
Member Benefit Information
- 2026 Summary of Benefits for 001
- 2026 Summary of Benefits for 001 (Spanish)
- 2026 Summary of Benefits for 002
- 2026 Summary of Benefits for 002 (Spanish)