Covered Drugs, Formulary & Forms

Use our online pharmacy and formulary search to find a Gold Kidney Health Plan network pharmacy and formulary

For more in-depth information, see our pharmacy and formulary documents below

Formulary Change Notice

Formulary Drug List (English)

2024 (Arizona)

2024 (Florida)

Formulary Drug List (Spanish)

2024 (Arizona)

2024 (Florida)

Prior Authorization Drug List

2024 (Arizona)

2024 (Florida)

Step Therapy Drug List

2024 (Arizona)

2024 (Florida)

Model Part D Coverage Determination and Redetermination Form

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