The Washtenaw Health Plan has a limited medication formulary . Exceptions to the formulary may be authorized on a case-by-case basis as determined by a clinical review process. A request for medication prior authorization form is availa- ble at the WHP Provider Formulary Information link below. Diabetes supplies (test strips, lancets and syringes) are part of the pharmacy benefit. Call 866-291-8691 if you have questions or need to speak to a nurse.

Complete Covered Medication List

(You will be taken to another website. You will be able to search or print the list.)

Medication Quick List (PDF) August 2019

(This is an easily printed 2 page list. All the medication forms and doses are not listed.)

Request for Medication Prior Authorization Form (PDF)
Pharmacy List (PDF) August 2019
Diabetes Supplies
WHP Provider Formulary Information/Materials/Resources
Durable Medical Equipment and Medical Supply Requests
  • P.O. Box 30125
  • Lansing, MI 48909
  • 866-291-8691
  • 517-394-4590