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Overview

A formulary (also called the "Drug List") is a list of drugs selected by the plan with help from a team of doctors and pharmacists. The Amerigroup Drug List includes all drug categories, guidelines and requirements set by Medicare. Medicare has approved the plan’s Drug List. This means your doctor or other prescriber can prescribe medication from a wide range of covered Medicare Part D drugs. The drug list may change throughout the year. We will send you notice before we make a change that affects you.

The drug list includes both brand-name and generic drugs. Generic drugs have the same active ingredients as brand name drugs and are approved by the FDA to be just as safe and effective. Generic drugs generally work as well as brand name drugs and usually cost less. There are generic substitutions available for many brand-name drugs.

You may search for Medicare part D drugs in several different ways. First you may search by using the drug name where products are listed by both generic (chemical) and brand (trade) names. Second, you may search using the therapeutic class of products you are looking for. You may direct any questions or comments to our customer service departments.

If the medication you are looking for is not listed and you have a question about your prescription coverage, please contact Member Services. You, your doctor or someone who is your representative can request that we make an exception and ask the plan to cover the drug remove restrictions from the drug.

Formulary Links

For a downloadable version of your formulary, visit your plan’s Pharmacy Prescription Services page.

For Classic (HMO), Select (HMO) and Dual Coordination (HMO SNP)

HMO and HMO SNP

For ESRD (HMO-POS SNP)

HMO-POS SNP


Step Therapy
Step Therapy - ESRD
Prior Authorization Criteria
Prior Authorization Criteria - ESRD

How do I request an exception to the formulary?

To submit a request for a coverage determination, utilization exception, formulary exception, or tiering exception, use the following form:

For more information, review the process for how to request an exception.