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Formulary (drug list) — These documents lists the drugs covered by each plan:
 Prescription reimbursement form
Prior authorization criteria (Prime)
Prior authorization criteria (Essential)
Transition policy (Español coming soon)
Medication therapy management, and drug and/or utilization management
Step therapy criteria
Extra help for prescription drug costs
People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for up to one hundred (100) percent of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call:
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1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7days a week;
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The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778; or
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Your local Social Security office.
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Your State Medicaid Office.
Assistance with Best Available Evidence for Low Income Subsidy
Monthly plan premiums for people who get extra help from
Medicare to help pay for their prescription drug costs
Y0089_MP3115 CMS Approved 10242012
Last updated: 2/21/2013 |
