The Upper Peninsula Health Plan (UPHP) covered drugs are selected by the plan with the help of a team of doctors and pharmacists. The drug list (Formulary) must meet requirements set by Medicare. Medicare has approved the UPHP formularies.
UPHP covers both brand-name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand-name drugs and are rated by the U.S. Food and Drug Administration to be as safe and effective as the brand-name drugs, while also costing less.
The UPHP Drug List may change throughout the year. Please see the “Formulary Change History” for your health plan below for further information or contact the plan for the most recent list of drugs.
Information on prior authorization, step therapy, formulary change history, quantity limits, out-of-network coverage, formulary exceptions and coverage determinations, and formulary appeals and grievances is below. (Please note: clicking some of these links will take you away from UPHP’s website).
Review the latest changes to UPHP’s formularies:
- UPHP Advantage & UPHP Choice Change History – information not available yet.
- UPHP MI Health Link Change History – information not available yet.
- CMS Coverage Determination Request Form
- UPHP Advantage & UPHP Choice Part D Coverage Determination Request Form
- UPHP MI Health Link Part D Coverage Determination Request Form
For information on the CMS Best Available Evidence policy, click here.
(Clicking on this link will take you away from UPHP’s website.)
Page Last Updated: 01/21/2019