Medications can play a significant role in your health care. The following information will help guide your decisions about medications and answer questions about your Medicare pharmacy benefits.
You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:
View a listing
Formulary (List of covered drugs)
of covered medications in our comprehensive formulary.
Utilization Management for Prescription Drugs
Some covered medications have additional requirements, such as a prior authorization requirement or limits on coverage. See requirements and access Prevea360 Medicare Advantage prior authorization forms
Part D Coverage Determinations, Exceptions, Appeals and Grievances
about Part D coverage determinations, exceptions, appeals and grievances.
Pharmacy Benefit Guideline FAQ
Read some common questions and answers
on Medicare pharmacy (Part D) topics.
Pharmacy Transition Process
Learn about our pharmacy transition process
for prescription drug coverage when you are a new member to plan, a returning member, when you change locations of care, and other special circumstances.
Find a Pharmacy
Search for nationwide pharmacy providers
available through Prevea360 Medicare Advantage plans. And learn about using out-of-network pharmacies.
Read about how some vaccines are covered
under the Part D benefit and when vaccines are covered under Medicare Part B.
Medication Therapy Management Program
Read about our Medication Therapy Management Program
Drug Overutilization Review Program
Learn about how we meet
the CMS requirement to prevent clinically inappropriate overuse of opioid medicines and acetaminophen.
You can contact Member Services if you need additional information, including:
- How we control the use of services and costs
- The number of appeals and grievances filed by our members
- A summary description of how we pay our doctors
- A description of our financial condition, including a summary of our most recent audit statement