What is the Prevea360 Medicare Advantage Formulary?

A formulary is a list of covered drugs created in consultation with a team of healthcare providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. 

The covered drugs are listed on the formulary as long as the medication is medically necessary, the prescription is filled at an in-network pharmacy, and other plan rules are followed. Please review your Evidence of Coverage for more detailed information about your formulary and how to fill your prescriptions. 

If a drug is not listed in your drug formulary, the product is not covered under your pharmacy benefit. If you decide to fill a prescription for a product not on the formulary, you are responsible for 100% of the cost. The cost is also not counted toward deductibles or out-of-pocket maximums.

View the 2023 Comprehensive formulary - updated 11/1/23

If you have a question about covered drugs or would like a formulary mailed to you, call our Customer Care Center at (877) 232-7566 (TTY: 711).


Members: speak with member services at 1-877-232-7566 (TTY: 711)

Not a member? Talk with a sales representative at 1-877-234-0126 (TTY: 711), including for alternate formats and languages.

Mailing Address:

Prevea360 Medicare Advantage
PO Box 56099
Madison, WI 53705

View our Medicare disclaimer.
Updated: 9/1/23