VIVA Medicare Plus Rx Forms and Resources

Pharmacy Benefits

Medicare Part D Formulary Intro (2008)

Medicare Part D Formulary (October 2008)

Medicare Part D Pharmacy Network (2008)

Medicare Part D Provider Exception Form (2008)

Medicare Part D Prior Authorizations (2008)

Medicare Part D Mail Order Form

Member Reimbursement Form

2009_Pharmacy_Network

Plus Rx Healthy Lifestyles Formulary (2009)

General

Rx Summary of Benefits (2008)

Evidence of Coverage (RX 2008)

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

Plus Rx Evidence of Coverage (2009)