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2021 VIRGINIA PREMIER ADVANTAGE ELITE

Virginia Premier is a HMO-SNP organization with a Medicare contract.  Enrollment in any Virginia Premier plan depends on contract renewal.

This online drug search represents the Comprehensive Formulary.  A comprehensive formulary is a list of all covered drugs selected by Virginia Premier 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.  Virginia Premier will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a Virginia Premier network pharmacy, and other plan rules are followed.

For questions about your benefits or enrollment please call our customer service number at 1-877-739-1370 or TTY users call 711, 7 days a week, 8am to 8pm (Oct. 1 – Feb. 14); Monday – Friday 8am to 8pm (Feb. 15 – Sept. 30) or visit our website at www.medicare.virginiapremier.com


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For information on initiating a Coverage Determination, including prior authorization, Tiering, utilization or exceptions, visit our website at www.medicare.virginiapremier.com or contact Envision at 1-855-408-0010 (TTY: 711), 24 hours 7 days a week.
Formulary Id: 21179
Formulary Effective Date: 09/01/2021
Updated:
08/2021
CMS Approval Date:
08/24/2021
CMS Version:
15

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