Upcoming Medicare prescription drug formulary and plan changes
AI Summary
UnitedHealthcare has updated their provider portal with information about upcoming Medicare prescription drug formulary changes and plan updates. The policy provides access to current and future drug formularies, prior authorization requirements, and specialty pharmacy programs, with the most recent commercial drug list effective January 1, 2026.
Action Required
By January 1, 2026: Billing team and providers should review the updated Commercial Prescription Drug List and Medicare Advantage Drug Formulary on the UnitedHealthcare provider portal. Verify current formulary status for commonly prescribed medications and update any prior authorization requirements. Check specialty pharmacy requirements for applicable medications to ensure proper billing and member access.
Plan Types
Medicare Advantage, Commercial
Specialties
all-specialties