Formulary Search

You can search the Vantage formulary to see if your drugs are covered using one of the three ways listed below.
If you are unable to locate your drug using any of the searches, please contact Member Services at 1-888-823-1910 (TTY/TDD 1-866-524-5144) because your drug may be covered as a generic drug under our plan.Hours of operation: November 15th through March 2nd: Seven (7) Days a Week 8:00 A.M. - 8:00 P.M. All other Dates: Monday Through Friday Week 8:00 A.M. - 8:00 P.M.

Our formulary can change during the year.

Search results will provide you detailed information about the drug, including which tier the drug is in, whether there is a quantity limit (QL) for that particular drug, and if prior authorization (PA) from Vantage is required before receiving the drug.

We may make certain changes to our formulary during the year. Changes in the formulary may affect which drugs are covered and how much you will pay when filling your prescription. The kinds of formulary changes we may make include:

• Adding or removing drugs from the formulary
• Adding prior authorizations, quantity limits, and/or step-therapy restrictions on a drug
• Moving a drug to a higher or lower cost-sharing tier

If we remove drugs from the formulary, or add prior authorizations, quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, and you are taking the drug affected by the change, you will be permitted to continue taking that drug for the remainder of the Plan year. However, if a brand name drug is replaced with a new generic drug, or our formulary is changed as a result of new information on a drug’s safety or effectiveness, you may be affected by this change. We will notify you of the change at least 60 days before the date that the change becomes effective or provide you with a 60-day supply at the pharmacy. This will give you an opportunity to work with your physician to switch to an appropriate drug that we cover or request a formulary exception before the change to the formulary takes effect. If a drug is removed from our formulary because the drug has been recalled from the pharmacies, we will not give 60 days notice before removing the drug from the formulary. Instead, we will remove the drug from our formulary immediately and notify members taking the drug about the change as soon as possible.

For questions about drugs requiring prior authorization or other formulary questions, call Vantage at 1-888-823-1910 (TTY/TDD 1-866-524-5144). Our formulary is updated monthly and can change during the year. Hours of operation: November 15th through March 1st: Seven (7) Days a Week 8:00 A.M. - 8:00 P.M. All other Dates: Monday Through Friday Week 8:00 A.M. - 8:00 P.M.

Click here for our policies and procedures regarding coverage determinations, quality assurance, grievances, and appeals.