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Your 2017 Formulary Effective January 1, 2017Please read: This document contains information about the drugs covered under your pharmacy benefit plan. For a complete list of covered drugs or if you
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How to fill out your 2017 prescription drug

01
Step 1: Gather all the necessary information. You will need your prescription drug plan card, a list of medications you currently take, and any receipts or records from previous medical expenses.
02
Step 2: Review your prescription drug plan. Understand the details of your plan, including coverage, copayments, and any restrictions or limitations.
03
Step 3: Identify any changes in your medications. Check if the drugs you were prescribed in 2017 have changed, and make a note of any new medications you have started taking.
04
Step 4: Complete the form. Fill out the prescription drug form with the required information. This may include your personal details, drug names and dosages, and any other relevant information.
05
Step 5: Submit the form. Once you have completed the form, submit it to your prescription drug plan provider. Follow their instructions for submission, which may involve mailing the form or submitting it online.
06
Step 6: Keep a copy for your records. Make sure to keep a copy of the filled-out form for your records.
07
Step 7: Follow up with your prescription drug plan provider. If you have any questions or concerns, reach out to your prescription drug plan provider for assistance.

Who needs your 2017 prescription drug?

01
Anyone who has a prescription drug plan for the year 2017 needs to fill out their prescription drug form. This includes individuals who require regular medication, have ongoing medical conditions, or anticipate needing prescription drugs during the year. It is important for all eligible individuals to complete the form to ensure accurate coverage and access to necessary medications.
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The prescription drug list includes all of the medications prescribed to an individual.
Healthcare providers and pharmacies are required to file the prescription drug list.
The prescription drug list can be filled out electronically or on paper, with all relevant medication information included.
The purpose of the prescription drug list is to keep a record of all prescribed medications for an individual, ensuring accurate and safe healthcare practices.
The prescription drug list must include the name of the medication, dosage, frequency, and prescribing healthcare provider.
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