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Forms & Resources

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2012 Forms & Resources

2011 Forms & Resources

VIVA MEDICARE Plus Rx Premier

VIVA MEDICARE Plus Rx Extra Value

Formulary Resources
Click here for the VIVA MEDICARE Plus prior authorization criteria. The formulary may change during the year. Members can find information regarding any mid-year non-maintenance formulary changes to the printed formulary by clicking here, calling Member Services, or reviewing your monthly Part D Explanation of Benefits (EOB) to see which of the drugs you are currently taking are coming off the VIVA MEDICARE Plus formulary. Click here to make a Prior Authorization or Exception Request

Related Files

Pharmacy Benefits

Additional Program Benefits