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Part D Prescription Drug Information

What is the Golden Advantage Plus Formulary?
A formulary is a list of drugs selected by Golden Advantage Plus in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Golden Advantage Plus will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a Golden Advantage Plus network pharmacy, and other plan rules are followed. We contract with over 60 pharmacies in Garrett, Allegany and Washington counties

The formulary is continuously under review and as changes occur, the version on the Web site is updated. The Web site has the most current and up-to-date version available.

For more detailed information about the Golden Advantage Plus prescription drug coverage, please review the Evidence of Coverage and other member materials, or contact Customer Service at (866) 651-7843 or TTY/TDD (800) 735-2258 24 hours a day/7 days a week

2007 2008
Member Materials Member Materials
2007 Abridged (partial) Formulary 2008 Abridged (partial) Formulary
2007 Comprehensive Formulary 2008 Comprehensive Formulary
Preferred Drug List Update 2008 Preferred Drug List Update
2007 Summary of Benefits 2008 Annual Notice of Change
2008 LIS (Low Income Subsidy) Rider
2008 Evidence of Coverage

Part D Information
Preferred Drug List Process
Mail Order Drugs
Medication Therapy Management Program
Out of Network Coverage
Pharmacy Transition of Care
Find a Pharmacy
Pharmacy Prior Authorization Form

Prescription Drug Exception and Appeals Process Click HERE

LIS (Low Income Subsidy) Information, Click HERE

Golden Advantage Plus has a contract with the Centers for Medicare and Medicaid (CMS). This contract renews each year. At the end of the year, the contract is reviewed and either Golden Advantage Plus or CMS can decide to end it. If this happens, you will receive a 90 day advance notice. Please see the Evidence of Coverage for more information.

Administered by:
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Schaller Anderson of Maryland, Incorporated.
All Rights Reserved.
CMS Accepted 12/8/07
H5539_4000_4006_08