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PHARMACEUTICAL MANAGEMENT
Bravo Health provides a pharmacy benefit to all of our Members. This benefit consists of a three-tier
formulary with a fourth tier for specialty injectible medications. All prescriptions require the Member to
pay a co-payment based on the medication’s formulary status. Our formulary can be found on line at
www.bravohealth.com
. Click on Providers, then Provider Forms and Information. You may also
request a printed copy of the formulary by contacting our Provider Services Department at 1-888-353-
3789.
Bravo Health’s formulary requires that some medications require prior authorization before they can be
dispensed. Please call 1-800-753-2851 for prior authorization. The formulary lists these medications
with the designation ‘PA.’ If you would like a copy of the criteria that Bravo Health uses to determine
coverage status for these medications, please visit our website. You may also request a printed copy of
these criteria by contacting our Provider Services Department.
Step Therapy
Bravo Health requires step therapy on the following 2 classes: Proton Pump Inhibitors and Lipid
lowering agents. The first line therapy for the proton pump inhibitor class will be either generic
Omeprazole or Zegerid. If you require any other medications for your Members in this class, prior
authorization will be required. For the lipid lowering class, first line medications are; Lovastatin,
Simvastatin, and Pravastatin. If you require any other medications in this class for your patients, they
will require prior authorization.
As always, remember to prescribe generics to our Members. Generic medications offer the lowest co-
payments and don’t require you to fill out any paperwork or receive callbacks from the retail pharmacies
asking you to switch to a formulary medication. If you do prescribe a brand name drug that has a
generic equivalent, the pharmacy will automatically switch the drug to the generic medication. If the
Member requires the brand name drug due to a medical failure or allergic reactions to a generic
medication, you must contact Bravo Health to seek prior authorization for the brand name medication.
