Estamos a su disposición para cubrir sus necesidades de medicamentos recetados.
Obtenga más información sobre su plan de farmacia, consejos para ahorrar dinero en medicamentos y la entrega a domicilio de productos de farmacia. Comencemos con lo básico.
¿Qué es la Parte D y qué cubre un plan de medicamentos recetados de la Parte D?
Most Medicare Advantage Plans include Part D coverage. Part D is the part of Medicare that provides coverage for prescription drugs. Refer to your plan materials for more information about your Part D benefit.
¿Dónde puedo encontrar mi lista de medicamentos?
Your drug list, also called a formulary, is a list of prescription drugs that are covered by your health plan. The drug list shows the most comprehensive drugs on your plan and is regularly updated. You can find your drug list in your secure member portal or on your health plan website.
¿Qué sucede si mi medicamento no está en la lista de medicamentos?
If you are currently on a drug that is not on your drug list, please check your plan's formulary for details on alternative drugs. Your health plan website also has an Alternative Drugs List with the most common drug alternatives that are covered by your plan.
Talk to your doctor to see if any alternative drugs will work for you.
¿Cuánto pagaré por mis medicamentos recetados?
If your plan has a deductible, you will pay the full cost of your medications until your deductible has been met for the year. You will not pay more than $2,100 per year out-of-pocket for your medications. You can use the Estimate Drug Costs tool through your secure member portal to see how much your out-of-pocket expenses may be and see similar drug options.
Medicare places drugs into different cost levels called “tiers.” Plan types may vary in the number of tiers offered.
On most of our plans, you will pay $0 for Tier 1 and Tier 6 medications, and $0 at preferred pharmacies for Tier 2 medications. We offer a wide variety of generic drugs on these tiers, and also cover generic erectile dysfunction drugs and select vitamins like folic acid, vitamin B12, and vitamin D2.
Other tiers may have a coinsurance where you pay a percentage of the total drug cost. Your costs can vary depending on the drug and pharmacy that you use.
Learn more about Medication Assistance.
¿Mi plan cubre inyecciones y vacunas?
Yes, all adult, ACIP-recommended Part D vaccines, such as RSV and Shingles, are available at no cost to you. In addition, your plan also covers Part B vaccines, such as Influenza, Pneumococcal, and COVID-19 at no cost to you.
¿Mi plan incluye insulina?
Yes, you can get a 30-day supply of each covered insulin for $35 or less.
¿Por qué debería usar una farmacia de la red?
You can save on out-of-pocket drug costs by using a preferred, in-network pharmacy.
We have over 60,000 pharmacies in our network with both local and retail pharmacies for you to choose from. Our partnerships with CVS and Walgreens and most grocers ensure that you can find a preferred, in-network pharmacy that is close to you.
Use the Find a Provider Tool in your member portal to find a preferred pharmacy near you.
¿Puedo recibir mis medicamentos recetados por correo en mi casa?
You can save time and trips to the pharmacy through Mail Order Pharmacy. Get up to a 90-day supply of your prescription drugs sent to your home with Express Scripts® Pharmacy. Your prescriptions will be automatically refilled and renewed so you don’t run out of your medication. This service is included with your health plan at no extra cost to you. Plus, standard shipping is free!
Your prescriptions are delivered to your door in discreet packaging. You can track your medication delivery and get updates by email, phone, or text to make sure you have your medications when you need them.
To get started, call Express Scripts at 1-833-750-0201 (TTY 711) 24 hours a day, 7 days a week, or visit express-scripts.com/rx to register.
¿Qué sucede si mis medicamentos requieren autorización o aprobación previa?
Algunos medicamentos requieren autorización previa, o aprobación previa, y se indican con las letras “PA” en la lista de medicamentos.
Si le recetan un medicamento que requiere aprobación previa, su médico tendrá que presentar un formulario de autorización previa en el que solicite el medicamento para usted.
¿Qué sucede si no puedo pagar mis medicamentos?
If you're having a hard time paying for the prescription drugs you need, don’t stop taking your medicine or reducing the amount you take. Taking your medication as prescribed by your doctor helps keep you healthy. Talk to your doctor about your medication options. Your doctor can recommend drugs that may cost less and may work better for you.
Taking a generic drug is one way to save money on your medications and we have over 2,300 generic drugs available. Generic drugs typically cost less than brand name drugs and have the same active ingredients as the brand-name medication. The Food & Drug Administration (FDA) reviews and approves all generic and brand name medications.
Compare brand name, generic and preferred medications that are available to you on your health plan website.
