Comprehensive Formulary PA Criteria Part D Claim Form
You can search the Vantage formulary to see if your drugs are covered according to drug tier, quantity limit (QL) and if prior authorization (PA) from Vantage is required before receiving the drug.
If you are unable to locate your drug using the above search, please contact Member Services at 1-888-823-1910 (TTY 1-866-524-5144 for the hearing impared) as your drug may be covered as a generic drug under our plan.
Click here for information about Formulary Changes.
Vantage Office of Group Benefits Website
130 DeSiard Street, Suite 300
Monroe, LA 71201
(318) 361-0900 · 1-888-823-1910
TTY 1-866-524-5144 (for the hearing impaired)
November 15th through March 2nd:
Seven(7) Days a Week
8:00 A.M. - 8:00 P.M. All other Dates:
Monday Through Friday
8:00 A.M. - 8:00 P.M.
