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  • ABOUT
    • About Retiree RxCare
  • PATIENTS
    • Find A Pharmacy
    • Enroll In Your Mail Order
    • File A Claim
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    • Authorization of Representative (AOR)
    • Direct Member Reimbursement (DMR) form
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Formulary

2023 Formularies

Click the links below to access current Formularies.

Base Formulary

Base Step Therapy Formulary

4T Step Therapy Formulary

4T Formulary

5T Step Therapy Formulary

5T Formulary

  • 2023 Formulary Changes

    Click the links below to access current Formularies.

    Base Formulary Changes 

    Base Step Therapy Formulary Changes 

    4T Step Therapy Formulary Changes

    4T Formulary Changes 

    5T Step Therapy Formulary Changes 

    5T Formulary Changes 

Spanish Formularies

Base Formulary

Base Step Therapy Formulary

4T Step Therapy Formulary

4T Formulary

5T Step Therapy Formulary

5T Formulary

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Website last updated 04/11/23

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