Pharmacy Search & Forms

Use our online pharmacy and formulary search to find a Gold Kidney Health Plan network pharmacy and formulary

Pharmacy Directory (Bilingual)

Verify that your current pharmacy is covered or find a new one in your area

Pharmacy Documents & Forms

2025 Formulary Drug List AZ - English

For the following plans:
Gold Heart & Diabetes
Gold Dialysis

Download English

For the following plans:
Gold Advantage

Download English

For the following plans:
Gold Heart & Diabetes Complete
Gold Dialysis Complete
Gold Circle Heart & Diabetes
Gold Circle Dialysis

Download English

2025 Formulary Drug List AZ - Spanish

For the following plans:
Gold Heart & Diabetes
Gold Dialysis

Download Spanish

For the following plans:
Gold Advantage

Download Spanish

For the following plans:
Gold Heart & Diabetes Complete
Gold Dialysis Complete
Gold Circle Heart & Diabetes
Gold Circle Dialysis

Download Spanish

2025 Pharmacy Directory AZ - English & Spanish

2025 Formulary Drug List FL - English

For the following plans:
Gold Heart & Diabetes
Gold Dialysis / Diálisis de Oro
Gold Health / Salud de Oro

Download English

For the following plans:
Gold Advantage

Download English

For the following plans:
Gold Heart & Diabetes Complete / Salud de Oro Completa
Gold Dialysis Complete / Diálisis de Oro Completa

Download English

2025 Formulary Drug List FL - Spanish

For the following plans:
Gold Heart & Diabetes
Gold Dialysis / Diálisis de Oro
Gold Health / Salud de Oro

Download Spanish

For the following plans:
Gold Advantage

Download Spanish

For the following plans:
Gold Heart & Diabetes Complete / Salud de Oro Completa
Gold Dialysis Complete / Diálisis de Oro Completa

Download Spanish

2025 Pharmacy Directory FL - English & Spanish

2025 Formulary Change Notice

2025 Prior Authorization Drug List

2025 Step Therapy Drug List

Medicare Prescription Payment Program (MPPP)

MedImpact Direct Mail® Program

Birdi Prescription Mail Order

Understanding the Transition Process

Submit Prior Authorization Request (Prescription Coverage Determination Request Form)

Prescription Drug Claim Form

Blank Personal Medication List (PML)

2024 Documents & Forms

2024 Formulary Drug List

2024 Formulary Change Notice

2024 Prior Authorization Drug List

2024 Step Therapy Drug List

Birdi Prescription Mail Order

Understanding the Transition Process

Prescription Coverage Determination Request Form

Prescription Drug Claim Form

Blank Personal Medication List (PML)

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