Drug Formulary


Prescription Drug Claim Form
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2025 Online Formulary
Central Health Medicare Plan 
Central Health Focus Plan (HMO C-SNP)
Central Health Ventura Medicare Plan(HMO)
Central Health San Mateo Medicare Plan
Central Health Savings Plan 
Central Health Jade Plan 
Central Health Premier Plan I 
Central Health Embrace Care Plan(HMO C-SNP) 25-1
Central Health Embrace Care Plan (HMO C-SNP)
Central Health Classic Care Plan I
Central Health Classic Care Plan II
Central Health Part B Savings Plan
Central Health Valor Plan(HMO)
Central Health Medi-Medi Plan I 
Central Health Medi- Medi Plan II
Central Health Dual Access Plan
Central Health Embrace Choice Plan 26-1
Central Health Embrace Choice Plan 26-2
 
 
 
2025 Comprehensive Formulary
Central Health Medicare Plan 
English 
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Armenian 
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2025 Prior Authorization Criteria - English (last updated on 10/15/2024)

 

Central Health Medi-Medi Plan II (HMO) 
Central Health Dual Access Plan (HMO)
Central Health Embrace Choice Plan (HMO)
2025 Step Therapy Criteria (1T)- English (last updated on 10/15/2024)

 

Central Health Medicare Plan (HMO)
Central Health Focus Plan (HMO C-SNP) 
Central Health Ventura Medicare Plan (HMO)
Central Health San Mateo Medicare Plan (HMO) 
Central Health Jade Plan (HMO)
Central Health Premier Plan I (HMO)
Central Health Embrace Care Plan (HMO C-SNP)
Central Health Classic Care Plan I (HMO) 
Central Health Classic Care Plan II (HMO)
Central Health Savings Plan (HMO)
Central Health Part B Savings Plan (HMO) 

2025 Step Therapy Criteria(6T) – English (last updated on 10/15/2024)