Drug Formulary

 2026 Molina Complete Care for MyCare Ohio (HMO D-SNP) Drug Formulary

 2025 Molina Dual Options MyCare Ohio Drug Formulary

 2026 Prior Authorization Grid

 2025 Prior Authorization Grid

 2026 Step Therapy Grid

 2025 Step Therapy Grid

 2026 Medicare Part D Drug (J-Code) Step Therapy Grid

 2025 Medicare Part D Drug (J-Code) Step Therapy Grid

 2026 Request for Medicare Prescription Drug Coverage Determination

 2025 Request for Medicare Prescription Drug Coverage Determination

 2026 Request for Redetermination of Medicare Prescription Drug Denial

 2025 Request for Redetermination of Medicare Prescription Drug Denial

 2026 Direct Member Reimbursement Form

 2025 Direct Member Reimbursement Form

 

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