Our Sales & Enrollment Team is available 8 a.m. to 8 p.m., 7 days a week through December 7th.

Comprehensive Formulary

Use the links below to access the INTEGRIS Health Partners+ Comprehensive and Abridged Formularies.

Abridged Formulary

Important Message About What You Pay for Vaccines - Our plan covers most Part D vaccines at no cost to you. Call Customer Services for more information.

Important Message About What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.

Part B Rebatable Drug Coinsurance Adjustment

Effective April 1, 2023, certain Medicare Part B drugs may have a lower coinsurance than what is stated in a member’s benefit documents. Members may pay a lower coinsurance if the price of the drug is rising faster than the rate of inflation. The Centers for Medicare & Medicaid Services (CMS) makes the determination on which Part B drugs qualify for the lower coinsurance and the coinsurance adjustment amount. CMS has the right to review and change this list of drugs up to 4 times a year. The Rebatable Drug Coinsurance Adjustment will occur through an enrollee refund if the mandatory reduction occurs after claims have been processed in 2024.

Part B Insulin Cost Sharing Cap

Starting July 1, 2023, Medicare Advantage plans must cover Part B insulin for use in insulin pumps at the copayment and coinsurance cap of $35 for a one-month supply of insulin.

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

2024 INTEGRIS Health Partners+ Utilization Management Criteria Documents
  Formulary Changes Prior Authorization Step Therapy Quantity Limits
JanuaryJanuary 2024 Formulary Changes - coming soonJanuary 2024 Prior Authorization CriteriaJanuary 2024 Step Therapy CriteriaSee comprehensive formulary for quantity limits.

HPMS Formulary ID: 00024112 Version 7
HPMS Formulary Approval Date: 9/29/2023
Updated: 01/2024

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