Pharmacy and Prescription Benefits

Passport Health Plan covers a comprehensive list of drugs chosen for their effectiveness. We choose these drugs with help from a team of doctors and pharmacists. Your drugs are covered when you show your member ID card at a network pharmacy whenever you get your prescriptions filled.

The formulary is a list of covered drugs. Passport Health Plan will generally cover any prescription drug listed in our formulary if:

  • the drug is medically necessary,
  • the prescription is filled at a Passport Health Plan network pharmacy,
  • and other plan rules are followed.


What drugs does Passport Health Plan cover?

For the Prescription Drugs you may need:

Search the 2022 Formulary - Passport Advantage (HMO D-SNP)

Search the 2022 Formulary - Passport Medicare Choice Care (HMO)

Important Pharmacy & Prescription Benefits Documents


Check the Member Materials and Forms to see all the standard benefits offered by Passport Health Plan.


2021 Passport Advantage Member Materials and Forms can be found here.

Please note: Members can contact the plan for a printed copy of the most recent list of drugs or view the link below. You can contact our Pharmacy team at (888) 665-1328, TTY 711, 7 days a week, 8:00 am to 8:00 pm local time.