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Key Things to Know about Drug Coverage

Our Plans

We have several Medicare Advantage Plans that include comprehensive medical coverage and drug coverage. 

  Standard Drug Coverage is Built in
Network PlatinumSelect (PPO)
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Network PlatinumChoice (PPO)
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Network PlatinumPlus Pharmacy (PPO)
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Network PlatinumPremier Pharmacy (PPO)
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Network Health Medicare Go (PPO)
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Network Health Medicare Anywhere (PPO)
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NetworkCares (PPO SNP)
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Help with Multiple Medications

If you take several medications, we have a program that can help you manage your medications and make them work the best for you.

Learn about Medication Therapy Management

Personal Medication List

Reminders

  • Learn more about changes in your pharmacy deductible for some drugs.
  • You can only be enrolled in one Part D prescription drug plan at a time. If you are enrolled in a Medicare Advantage Part D plan, you must receive the Part D coverage through that plan.
  • If you do not add prescription drug coverage when you are first eligible (and you do not have coverage that’s as good as or better than Medicare Part D coverage) and you choose to add it later, you will have to pay a penalty.

Drug Forms for Members

Prescription Drug Claim Form

Submit a Request for a Drug Coverage DeterminationMembers have the right to request coverage for a particular prescription drug.

Redetermination Request Form - Members have the right to ask us to reconsider a coverage decision made for a particular prescription drug.

Other Drug Coverage Information

Extra Help (Low-Income Subsidy) Table - This shows what your premium will be if you get extra help from Medicare to pay for your prescription drug costs.

Programs to Ensure Safe and Effective Use of Medications (Utilization Management)

Prescription Drug Coverage and Your Rights

Transition Plan Policy

CMS Best Available Evidence Policy 

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