Provider and Pharmacy Directory Notice

2017 Summary of Benefits

2017 Multi-Language Insert

Plan Ratings document

Tribute Part D Coverage Determination Request Form

Tribute Part D Coverage Redetermination Request Form

Medication Transition
This process has been put in place to aid our members in managing their drug coverage when transitioning from one plan to another where a certain medication may not be covered by our plan.

Medication Therapy Monitoring (MTM)
Aids our members with the more complex medication needs such as multiple medications or chronic medical condition.

2017 Comprehensive Formulary (Last Updated November 01, 2017)

2017 Formulary (Prescription Drugs) Changes (Last Updated November 01, 2017)

2017 Prior Authorization for Pharmacy (Last Updated November 01, 2017)

Many medications offered through Tribute require prior authorization to ensure for appropriateness and medical necessity. The link above will show the various categories of drugs requiring prior approval

2017 Step Therapy (Last Updated November 01, 2017)

Some medications require other medications to be used prior to another prescription. The link above indicated applicable medications.

2017 Quantity Limit Therapy (Last Updated November 01, 2017)