2022 Senior Health Plan

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Comprehensive Formulary

Use the links below to access the Senior Health Plan Comprehensive and Abridged Formularies.


Abridged Formulary


Extended Day Supply for Platinum and Platinum Plus members on Tier 1 medications (100 days or more)

Enjoy the convenience of extended supplies on select Tier 1 medications (100 days or more) and pay $0 copay.


Formulary Changes and Utilization Management Criteria

2022 Senior Health Plan Utilization Management Criteria Documents
  Formulary Changes Prior Authorization Step Therapy Quantity Limits
JanuaryJanuary 2022 Formulary ChangesJanuary 2022 Prior Authorization Criteria - updated 12/2/2021January 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
FebruaryFebruary 2022 Formulary ChangesFebruary 2022 Prior Authorization CriteriaFebruary 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
MarchMarch 2022 Formulary ChangesMarch 2022 Prior Authorization CriteriaMarch 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
AprilApril 2022 Formulary ChangesApril 2022 Prior Authorization CriteriaApril 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
MayMay 2022 Formulary ChangesMay 2022 Prior Authorization CriteriaMay 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
JuneJune 2022 Formulary ChangesJune 2022 Prior Authorization CriteriaJune 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
JulyJuly 2022 Formulary ChangesJuly 2022 Prior Authorization CriteriaJuly 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
AugustAugust 2022 Formulary ChangesAugust 2022 Prior Authorization CriteriaAugust 2022 Step TherapySee comprehensive formulary for quantity limits.
SeptemberSeptember 2022 Formulary ChangesSeptember 2022 Prior Authorization CriteriaSeptember 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
OctoberOctober 2022 Formulary ChangesOctober 2022 Prior Authorization CriteriaOctober 2022 Step TherapySee comprehensive formulary for quantity limits.
NovemberNovember 2022 Formulary ChangesNovember 2022 Prior Authorization CriteriaNovember 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
DecemberDecember 2022 Formulary ChangesDecember 2022 Prior Authorization CriteriaDecember 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.

HPMS Formulary ID: 00022069 Version 18
HPMS Formulary Approval Date: 11/22/2022
Updated: 12/2022



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Need Assistance?

If you have questions about joining Senior Health Plan, call our Sales & Marketing Team at (918) 594-5275, Monday through Friday from 8:00 am to 6:00 pm.

If you are a current member, please call Customer Service at (918) 594-5323. We are available Monday through Friday from 8:00 am to 8:00 pm. From October 1 through March 31, our hours include Saturdays, Sundays and some holidays.

TTY/TDD users should call 1-800-722-0353.

If you would like to contact Senior Health Plan via mail, please use the following address:

Senior Health Plan Customer Service
P.O. Box 3327
Tulsa, OK 74101-3327

You can also get information about the Medicare program and Medicare health plans by visiting www.medicare.gov on the Web or by calling 1-800-MEDICARE (1-800-633-4227). Medicare customer service representatives are available 24 hours a day, 7 days a week to answer questions about Medicare. TTY/TDD users should call 1-877-486-2048.

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