Provider Information
- 2024 Provider Manual
- Participating Providers
- Participating Pharmacies
- Model of Care Training and Attestation
- 2024 Provider Quick Reference Guide (Texas Advantage Plan)
- Provider Information Update
- 2024 Provider Coverage Determination Form
Medical Information and Authorization
Pharmacy Information and Authorization
Formulary 2024
- 2024 Comprehensive Formulary (Prescription Drugs)
(last updated 12/1/2024) - 2024 Comprehensive Formulary (Prescription Drugs) (Spanish)
(last updated 12/1/2024) - 2024 Prior Authorization Criteria
(last updated 12/1/2024) - 2024 Step Therapy Criteria
(last updated 12/1/2024) - 2024 Formulary (Prescription Drugs) Search Tool
- Online Part D Coverage Determination/Redetermination
Member Benefit Information
- 2024 Advantage Plan Summary of Benefits
(contains multi-language insert) - 2024 Advantage Plan Summary of Benefits (Spanish)
Page Last Updated: 11/27/2024