Pharmacy Information &

Prescription Drug Coverage

Prescription Drug Formulary

Aspire Health Plan’s prescription drug formulary or “Drug list” is a list of prescription drugs covered by the plan. The drugs on this list are selected by the plan with the help of doctors and pharmacists. The list includes both brand name and generic drugs.

2024 Pharmacy Information

  • Step Therapy

    In some cases, Aspire Health Plan may require you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. This is called Step Therapy. For more details on Step Therapy, view the document below.

    2024 Step Therapy Updates (PDF):  English

  • Prior Authorization

    You have the right to request an exception to the Aspire Health Plan Drug Formulary. To learn more on the types of exceptions, view the document below.

    2024 Prior Authorization Updates (PDF):  English

  • Coverage Determination Request

    2024 Request for Medicare Prescription Drug Coverage Determination (PDF):  English | Español (Coming Soon)

  • Mail-Order Prescriptions

    If you rely on regular or long-term medications, there may be a better way to get your prescriptions filled. Birdi Rx is home delivery and a smart, simple way for you to get prescriptions delivered to your door.

    2024 Home Delivery Registration Form (PDF):  English  | Español

  • Out-of-Network Pharmacy Coverage

    For a detailed description of our out-of-network pharmacy rules, check out our Evidence of Coverage documents located on our 2024 Plan Documents page.

2023 Pharmacy Information

  • Step Therapy

    In some cases, Aspire Health Plan may require you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. This is called Step Therapy. For more details on Step Therapy, view the document below.

    2023 Step Therapy Updates (PDF):  English

  • Prior Authorization

    You have the right to request an exception to the Aspire Health Plan Drug Formulary. To learn more on the types of exceptions, view the document below.

    2023 Prior Authorization Updates (PDF):  English

  • Coverage Determination Request

    2023 Request for Medicare Prescription Drug Coverage Determination (PDF):  English | Español

  • Mail-Order Prescriptions

    If you rely on regular or long-term medications, there may be a better way to get your prescriptions filled. Birdi Rx is home delivery and a smart, simple way for you to get prescriptions delivered to your door.

    2023 Home Delivery Registration Form (PDF):  English  | Español

  • Out-of-Network Pharmacy Coverage

    For a detailed description of our out-of-network pharmacy rules, check out our Evidence of Coverage documents located on our 2023 Plan Documents page.