Pharmacy

Information you and your Tufts Health Plan patients need concerning our pharmacy benefit and programs.

COMMERCIAL
Formularies
Standard Formulary
Rhode Island Formulary
Generic Focused Formulary for Select Network and Connector Commonwealth Saver Plans members>
Preferred Drug List

Medical Necessity Guidelines
Pharmacy Medical Necessity Guidelines Clinical criteria for drugs with prior authorization or coverage limitation requirements

Coverage Requests
Universal Pharmacy Medical Review Request Form Request coverage for drugs under our pharmacy management programs
Prior Authorization Prescription Medications for CareLink^SM - Tufts Health Plan
Anti-Obesity Medications Coverage Request Form

TUFTS HEALTH PLAN MEDICARE PREFERRED
Formularies
Tufts Medicare Preferred HMO Formulary
Tufts Medicare Preferred PDP Formulary
Tufts Medicare Preferred Generic Drug List For commonly prescribed Therapeutic Categories and Drug Classes

Medical Necessity Guidelines
Tufts Health Plan Medicare Preferred Prior Authorization and Step Therapy Guidelines Clinical criteria for drugs with prior authorization or coverage limitation requirements

Coverage Requests
Medicare Part D Coverage Determination Request Form Request coverage for drugs under our pharmacy management programs for Tufts Medicare Preferred members
Information for Pharmacists Concerning Tufts Medicare Preferred
Tufts Medicare Preferred Prescription Drug Plan Coverage Determination and Prior Authorization Request Form Request coverage for Tufts Medicare Preferred Prescription Drug Plan members to determine coverage under Medicare Part B or
Part D.

PHARMACY PROGRAMS
Tufts Health Plan Pharmacy Programs
e-Prescribing Initiative

Pharmacy Updates  An overview of Tufts Health Plan's commercial pharmacy updates for the current and previous years