providers

Pharmacy

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

Commercial Formularies
Standard Formulary PDF
Rhode Island Formulary PDF
Generic Focused Formulary for Select Network members PDF
Preferred Drug List PDF

Tufts Health Plan Medicare Preferred Formulary
Tufts Medicare Preferred Formulary PDF
Tufts Medicare Preferred Pharmacy Medical Necessity Guidelines PDF
Tufts Medicare Preferred Generic Drug List PDF For commonly prescribed Therapeutic Categories and Drug Classes
Information for Pharmacists Concerning Tufts Medicare Preferred PDF

Medical Necessity Guidelines and Coverage Requests
Pharmacy Medical Necessity Guidelines Clinical criteria for drugs with prior authorization or coverage limitation requirements
Universal Pharmacy Medical Review Request Form Request coverage for drugs under our pharmacy management programs
Prior Authorization Prescription Medications for CareLinkSM - Tufts Health Plan PDF
Medicare Part D Coverage Determination Request Form PDF Request coverage for drugs under our pharmacy management programs for Tufts Medicare Preferred members
Anti-Obesity Authorization Form PDF

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