Essential Rx 2024 Formulary (List of Covered Drugs)
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) | 11/1/2024 |
Prior Authorization Criteria (PDF) | 11/1/2024 |
Aspirus Formulary Exception Criteria (PDF) | 4/1/2024 |
Formulary Change Notice (PDF) | 11/1/2024 |
Part B Medical Injectable Drug Authorization List (PDF) | 11/13/2024 |
Diabetic Supplies List (PDF) | 5/1/2024 |
Non-Preferred CGM and Testing Criteria (PDF) | 10/1/2024 |
Part D Information |