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Important Documents

For Your Convenience

Certain documents are of the utmost importance to many Medicare Advantage members. We’ve compiled this information in one place for your convenience. Below you’ll find this year’s formulary, prior authorization guidelines, a pharmacy directory, and more.

If you have questions or need assistance with any of these documents, please contact CDPHP member services.

Annual Formulary
A list of covered drugs for 2021.

Annual Notice of Change (ANOC) and Evidence of Coverage (EOC)
The ANOC details changes in coverage, cost, or service area, effective January 1, while the EOC is a comprehensive document that outlines benefits, cost-share, how the plan works, and what the plan covers. 

Prior Authorization Drugs – Part B vs. Part D
A list of drugs subject to a Part B vs. D determination for all members with Part D coverage.

Part D Prior Authorization Guidelines Grid
Information on services that require prior authorization through the CDPHP pharmacy department.

Pharmacy Directory
A list of network pharmacies, along with their address and phone number, to help you find specific locations near you.

Medicare Advantage Part D Step Therapy Drug List
Information about medications on the step therapy list for 2021.

Medicare Advantage Part D High-Risk Medications List
A list of medications that require prior authorization due to increased risks.

Multi-Language Insert
Access to interpreter services for non-English language speakers.

CDPHP Medicare Advantage is an HMO and PPO plan with a Medicare contract. Enrollment in CDPHP Medicare Advantage depends on contract renewal.

Y0019_21_13605 - last updated 10/29/2020