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  5. Medical Policies - Pharmacy

Medical Policies - Pharmacy

  • Off-Label Drug Use Commercial Pharmacy 12

    PDF, 307 KBLast Updated: 02/06/2025

    PDF, 307 KBLast Updated: 02/06/2025

  • Off-Label Drug Use Medicaid Pharmacy 12

    PDF, 340 KBLast Updated: 02/06/2025

    PDF, 340 KBLast Updated: 02/06/2025

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© Sentara Health Plans 2025, PO Box 66189, Virginia Beach, Virginia 23466

Sentara Health Plans is the trade name for Sentara Health Plans, Sentara Health Insurance Company, Sentara Health Administration, Inc., and Sentara Behavioral Health Services, Inc. Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products are issued and underwritten by Sentara Health Plans. Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans and the Centers for Medicare and Medicaid Services (CMS). Medicaid and FAMIS products are administered under an agreement with Sentara Health Plans and the Virginia Department of Medical Assistance Services (DMAS).