Active Plans & Non-Medicare Retirees Handouts & Forms

1. Active Plans Only – ACA Preventive Services Drug List
2. 1/1/2025 Performance Drug List
3. Compounded Drug- Plan Guidelines Handout

Coming in 2025:

1. Prescription Drug Program Handout
2. Mail Service Benefit Flyer
3. Approaching Medicare Handout

1. Prescription Drug Program Appeal Request Form