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Aspirus Health Plan Medicare plans

  • Essential Rx (PPO)

Formulary and prescription drug calculator

Use this tool to see what you can expect to pay for your medication

Drug calculator

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) 2/1/2024
Prior Authorization Criteria (PDF) 2/1/2024
Aspirus Formulary Exception Criteria (PDF) 1/21/2022
Formulary Change Notice (PDF) Coming soon
Part B Medical Injectable Drug Authorization List (PDF) 2/6/2024
Diabetic Supplies List (PDF) 5/1/2023
Part D Information