Essential Rx 2024 Formulary (List of Covered Drugs) with cost estimates
Aspirus Health Plan Medicare plans
- Essential Rx (PPO)
More formulary documents
| Document | Last Updated Date |
| Drug search tool (formulary with coverage limitations and drug requirements) |
10/1/2023 |
| Formulary (List of Covered Drugs) (PDF) | 4/1/2024 |
| Prior Authorization Criteria (PDF) | 4/1/2024 |
| Aspirus Formulary Exception Criteria (PDF) | 4/1/2024 |
| Formulary Change Notice (PDF) | 3/1/2024 |
| Part B Medical Injectable Drug Authorization List (PDF) | 4/1/2024 |
| Diabetic Supplies List (PDF) | 5/1/2023 |
| Part D Information |