{ "formulary": [ { "_comment": "Use this for Links, remember to add URL, label, and title, type is empty", "id": "Template", "category": "Formulary", "name": "Expanded Searchable Formulary", "GroupNumberId": ["Add Group Number here"], "type": "", "links": { "english": { "url": "add URL here", "label": "add Label here", "title": "add Title here. This link opens in a new window" } } }, { "_comment": "Use this for PDF, including English and Spanish versions, type PDF", "id": "", "category": "Formulary", "name": "Expanded Formulary", "GroupNumberId": ["Add Group Number here"], "type": "PDF", "links": { "english": { "url": "/documents/medical-provider-directory-en.pdf", "label": "English", "title": "Medical Provider Directory in English" }, "spanish": { "url": "/documents/medical-provider-directory-es.pdf", "label": "Spanish", "title": "Directorio de proveedores médicos en español" } } }, { "id": "", "category": "Formulary", "name": "Expanded Formulary", "GroupNumberId": ["2MMA", "2MMB", "2MMC", "2MME", "2MMF", "2MMG", "2MMK", "2MML", "2MMN", "2MMP", "2MMQ", "2MMR", "2MMS"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-ma-formulary-ppo.pdf", "label": "English", "title": "Expanded Formulary in English" }, "spanish": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-ma-formulary-ppo-spanish.pdf", "label": "Spanish", "title": "Expanded Formulary in Spanish" } } }, { "id": "", "category": "Formulary", "name": "Expanded Formulary Changes", "GroupNumberId": ["2MMA", "2MMB", "2MMC", "2MME", "2MMF", "2MMG", "2MMK", "2MML", "2MMN", "2MMP", "2MMQ", "2MMR", "2MMS"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-ma-formulary-ppo-changes.pdf", "label": "English", "title": "Expanded Formulary Changes in English" }, "spanish": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-ma-formulary-ppo-changes-spanish.pdf", "label": "Spanish", "title": "Expanded Formulary Changes in Spanish" } } }, { "id": "", "category": "Formulary", "name": "Expanded Prior Authorization Criteria", "GroupNumberId": ["2MMA", "2MMB", "2MMC", "2MME", "2MMF", "2MMG", "2MMK", "2MML", "2MMN", "2MMP", "2MMQ", "2MMR", "2MMS"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-ma-prior-auth-ppo.pdf", "label": "English", "title": "Expanded Prior Authorization Criteria in English" }, "spanish": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-ma-prior-auth-ppo-spanish.pdf", "label": "Spanish", "title": "Expanded Prior Authorization Criteria in Spanish" } } }, { "id": "", "category": "Formulary", "name": "Expanded Step Therapy Criteria", "GroupNumberId": ["2MMA", "2MMB", "2MMC", "2MME", "2MMF", "2MMG", "2MMK", "2MML", "2MMN", "2MMP", "2MMQ", "2MMR", "2MMS"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-ma-step-therapy-ppo.pdf", "label": "English", "title": "Expanded Step Therapy Criteria in English" }, "spanish": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-ma-step-therapy-ppo-spanish.pdf", "label": "Spanish", "title": "Expanded Step Therapy Criteria in Spanish" } } }, { "id": "", "category": "Formulary", "name": "Expanded Searchable Formulary", "GroupNumberId": ["2MMA", "2MMB", "2MMC", "2MME", "2MMF", "2MMG", "2MMK", "2MML", "2MMN", "2MMP", "2MMQ", "2MMR", "2MMS"], "type": "", "links": { "english": { "url": "https://www.medicareplanrx.com/jccf/carefirst_exp_ppo_formulary_26.html", "label": "Searchable 2026 Formulary", "title": "Searchable 2026 Formulary. This link opens in a new window" } } }, { "id": "", "category": "Formulary", "name": "Group Plus Formulary", "GroupNumberId": ["2MMM", "2MMT", "2MMU"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-groupplus-formulary.pdf", "label": "English", "title": "Group Plus Formulary in English" }, "spanish": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-groupplus-formulary-spanish.pdf", "label": "Spanish", "title": "Group Plus Formulary in Spanish" } } }, { "id": "", "category": "Formulary", "name": "Group Plus Formulary Changes", "GroupNumberId": ["2MMM", "2MMT", "2MMU"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-groupplus-formulary-changes.pdf", "label": "English", "title": "Group Plus Formulary Changes in English" }, "spanish": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-groupplus-formulary-changes-spanish.pdf", "label": "Spanish", "title": "Group Plus Formulary Changes in Spanish" } } }, { "id": "", "category": "Formulary", "name": "Group Plus Prior Authorization Criteria", "GroupNumberId": ["2MMM", "2MMT", "2MMU"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-groupplus-pa-criteria.pdf", "label": "English", "title": "Group Plus Prior Authorization Criteria in English" }, "spanish": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-groupplus-pa-criteria-spanish.pdf", "label": "Spanish", "title": "Group Plus Prior Authorization Criteria in Spanish" } } }, { "id": "", "category": "Formulary", "name": "Group Plus Step Therapy Criteria", "GroupNumberId": ["2MMM", "2MMT", "2MMU"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-groupplus-step-therapy.pdf", "label": "English", "title": "Group Plus Step Therapy Criteria in English" }, "spanish": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-groupplus-step-therapy-spanish.pdf", "label": "Spanish", "title": "Group Plus Step Therapy Criteria in Spanish" } } }, { "id": "", "category": "Formulary", "name": "Group Plus Searchable Formulary", "GroupNumberId": ["2MMM", "2MMT", "2MMU"], "type": "", "links": { "english": { "url": "https://www.medicareplanrx.com/MedicationPricingTool/planInfo.do?clientId=284®ionId=1&year=2026&contractId=H7379&planId=002&lang=en&formularySearch=true&displayFormularyRegion=false&displayFormularyChangePlan=false&displayPricingRegion=false&displayPricingChangePlan=false", "label": "Group Plus Searchable Formulary", "title": "Group Plus Searchable Formulary. This link opens in a new window" } } }, { "_comment": "Pharmacy Directory Section" }, { "id": "", "category": "Pharmacy", "name": "Pharmacy Directory", "GroupNumberId": ["2MMA", "2MMB", "2MMC", "2MME", "2MMF", "2MMG", "2MMK", "2MML", "2MMM", "2MMN", "2MMP", "2MMQ", "2MMR", "2MMS", "2MMT", "2MMU"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-ma-pharmacy-directory-ppo.pdf", "label": "English", "title": "Pharmacy Directory in English" }, "spanish": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-ma-pharmacy-directory-ppo-spanish.pdf", "label": "Spanish", "title": "Pharmacy Directory in Spanish" } } }, { "id": "", "category": "Pharmacy", "name": "Pharmacy Search", "GroupNumberId": ["2MMA", "2MMB", "2MMC", "2MME", "2MMF", "2MMG", "2MMK", "2MML", "2MMM", "2MMN", "2MMP", "2MMQ", "2MMR", "2MMS", "2MMT", "2MMU"], "type": "", "links": { "english": { "url": "https://www.medicareplanrx.com/PharmacyLocator/?contractId=H7379&lang=en&year=2026&clientId=190", "label": "Pharmacy Search", "title": "Pharmacy Search. This link opens in a new window" } } }, { "_comment": "Additional coverage documents section" }, { "id": "", "category": "Additional coverage documents", "GroupNumberId": ["2MMA", "2MMB", "2MMC", "2MME", "2MMF", "2MMG", "2MML", "2MMN", "2MMP" ], "name": "Standard Rider 4T", "type": "PDF", "links": { "english": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-standard-rider.pdf", "label": "English", "title": "Medical Provider Directory in English" }, "spanish": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-standard-rider-spanish.pdf", "label": "Spanish", "title": "Medical Provider Directory in Spanish" } } }, { "id": "", "category": "Additional coverage documents", "name": "Standard Rider 3T", "GroupNumberId": "2MMM", "type": "PDF", "links": { "english": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-standard-rider-3T.pdf", "label": "English", "title": "Standard Rider 3T in English" }, "spanish": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-standard-rider-3T-spanish.pdf", "label": "Spanish", "title": "Standard Rider 3T in Spanish" } } }, { "id": "", "category": "Additional coverage documents", "name": "Enhanced Rider", "GroupNumberId": ["2MMK", "2MMQ", "2MMR"], "type": "PDF", "links": { "english": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-enhanced-rider.pdf", "label": "English", "title": "Enhanced Rider in English" }, "spanish": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-enhanced-rider-spanish.pdf", "label": "Spanish", "title": "Enhanced Rider in Spanish" } } }, { "id": "", "category": "Additional coverage documents", "name": "Standard PA Rider", "GroupNumberId": ["2MMA","2MMB","2MMC", "2MME", "2MMF","2MMG", "2MML", "2MMM", "2MMN", "2MMP"], "type": "PDF", "links": { "english": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-standard-pa-rider.pdf", "label": "English", "title": "Standard PA Rider in English" }, "spanish": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-standard-pa-rider-spanish.pdf", "label": "Spanish", "title": "Standard PA Rider in Spanish" } } }, { "id": "", "category": "Additional coverage documents", "name": "Enhanced PA Rider", "GroupNumberId": ["2MMK", "2MMQ", "2MMR"], "type": "PDF", "links": { "english": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-enhanced-pa-rider.pdf", "label": "English", "title": "Enhanced PA Rider in English" }, "spanish": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-enhanced-pa-rider-spanish.pdf", "label": "Spanish", "title": "Enhanced PA Rider in Spanish" } } }, { "id": "", "category": "Additional coverage documents", "name": "Lean Rider 3T", "GroupNumberId": ["2MMU"], "type": "PDF", "links": { "english": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-lean-rider-3T.pdf", "label": "English", "title": "Lean Rider 3T in English" }, "spanish": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-lean-rider-3T-spanish.pdf", "label": "Spanish", "title": "Lean Rider 3T in Spanish" } } }, { "id": "", "category": "Additional coverage documents", "name": "Lean Rider 4T", "GroupNumberId": ["2MMS"], "type": "PDF", "links": { "english": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-lean-rider.pdf", "label": "English", "title": "Lean Rider in English" }, "spanish": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-lean-rider-spanish.pdf", "label": "Spanish", "title": "Lean Rider in Spanish" } } }, { "id": "", "category": "Additional coverage documents", "name": "Lean PA Rider", "GroupNumberId": ["2MMS", "2MMU"], "type": "PDF", "links": { "english": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-lean-pa-rider.pdf", "label": "English", "title": "Lean PA Rider in English" }, "spanish": { "url": "https://member.carefirst.com/carefirst-resources/pdf/2026-gma-lean-pa-rider-spanish.pdf", "label": "Spanish", "title": "Lean PA Rider in Spanish" } } }, { "id": "", "category": "Additional coverage documents", "name": "2026 Preventive Drug List", "GroupNumberId": "2MMR", "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-gma-aca-preventive-drug-list.pdf", "label": "English", "title": "2026 Preventive Drug List in English" } } }, { "id": "", "category": "Additional coverage documents", "name": "2026 Enhanced Preventive Drug List", "GroupNumberId": "2MMT", "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-gma-enhanced-preventive-drug-list.pdf", "label": "English", "title": "2026 Enhanced Preventive Drug List in English" } } }, { "id": "", "category": "Additional coverage documents", "name": "2026 Part D Diabetic Supply List", "GroupNumberId": ["2MMT", "2MMU"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-gma-part-d-diabetic-supply-list.pdf", "label": "English", "title": "2026 Part D Diabetic Supply List in English" } } }, { "id": "", "category": "Additional coverage documents", "name": "Annual Medicare Formulary Updates", "GroupNumberId": ["2MMA", "2MMB", "2MMC", "2MME", "2MMF", "2MMG", "2MMK", "2MML", "2MMM", "2MMN", "2MMP", "2MMQ", "2MMR", "2MMS", "2MMT", "2MMU"], "type": "PDF", "links": { "english": { "url": "https://individual.carefirst.com/carefirst-resources/pdf/2026-medicare-formulary-updates.pdf", "label": "English", "title": "Annual Medicare Formulary Updates in English" } } } ] }