Formulary lists of approved drugs

Use our searchable database and PDFs to learn whether your prescription drug is covered by your Providence Medicare Advantage Plan, as well as information about prior authorization and step therapy. Please select the link below that corresponds to your plan.

For Medicare Part D plans ›

  • For members of Providence Medicare Choice + RX (HMO-POS), Providence Medicare Compass + RX (HMO-POS), Providence Medicare Enrich + RX (HMO), Providence Medicare Extra + RX (HMO), Providence Medicare Extra Part B Only + RX (HMO), Providence Medicare Harbor + RX (HMO), Providence Medicare Latitude + RX (HMO-POS), Providence Medicare Prime + RX (HMO-POS), Providence Medicare Summit + RX (HMO-POS)

For Medicare Dual Plus plans ›

  • For members of Providence Medicare Dual Plus (HMO SNP)


Information for all Providence Medicare Advantage Plans members with prescription drug benefits:


The formulary may change at any time. You will receive notice when necessary.