VIVA Medicare Plus Rx Extra Care Forms and Resources

Pharmacy Benefits

2008 Formulary Intro (2008)

Extra Care Formulary (October 2008)

Medicare Part D Pharmacy Network (2008)

Medicare Part D Prior Authorizations (2008)

Medicare Part D Provider Exception Form (2008)

Medicare Part D Mail Order Form

Member Reimbursement Form

ExCare_Formulary (2009)

2009_Pharmacy_Network

General

Extra Care Evidence of Coverage (2008)

Extra Care Summary of Benefits (2008)

Delta Dental Extra Care EOC (2008)

Delta Dental Provider Directory (2008)

Plus Rx Extra Care 2009 Summary of Benefits (January 1, 2009 - December 31, 2009 Central Alabama)

Extra Care Evidence of Coverage (2009)

Delta Care Dental Coverage Guide (2009)