Pharmacy Services

Click the categories below for important pharmacy documents and resources. 

Formularies

Child Health Plus (CHP)

2021 Drug Formulary (PDF)

2021 Formulary Quick Reference Guide (PDF)


HealthierLife (HARP) and Medicaid Managed Care

2021 Drug Formulary (PDF)

2021 Formulary Quick Reference Guide (PDF)


Qualified Health Plans (Metal-Level Products)

2021 Formulary (PDF)

2020 Formulary (PDF)


Essential Plan

2021 Formulary (PDF)

2020 Formulary (PDF)


Fidelis Medicare Advantage and Dual Advantage Plans

2021

2021 Formulary (PDF)

Changes to Fidelis Care’s Medicare Formulary (PDF)

2021 Step Therapy Criteria (PDF)

2021 Prior Authorization (PA) Criteria (PDF)


2020

2020 Formulary (PDF)

2020 Step Therapy Criteria (PDF)

2020 Prior Authorization (PA) Criteria (PDF)


Provider Access Online

Verify member eligibility, check claims, and more.

Manuals and Forms

Provider manuals, tip sheets, important forms, and applications. 

Authorization Grids

Authorization Grids for Medicare, Medicaid, Child Health Plus, and NY State of Health Marketplace plans.