Medica has a comprehensive formulary to help you maximize your prescription drug benefit. You can print the formularies below and take to the Doctor.

What is an Open Formulary?	What is a Closed Formulary?
A formulary in which all Part D eligible medications are covered, but at various levels of cost sharing. Utilization management edits such as prior authorization, step therapy, and quantity limits still apply to this type of formulary. 2008 Prime Solution Part D Rider Open Formulary 2008 Medica Advantage Solution Open Formulary 2008 Medica Complete Solution Open Formulary 2008 Medica Group Prime Solution Open Formulary 2008 Medica Group Advantage Solution Open Formulary View our formulary changes	Within a given therapeutic class, a closed formulary limits the number of eligible Part D medications that will be reimbursed by the plan. 2008 Advantage Solution Choice Closed Formulary 2008 Medica Dual Solution Closed Formulary 2008 Medica AccessAbility Solution Closed Formulary 2008 Medica Group Prime Solution Closed Formulary 2008 Employer Group Wrap additions to the closed formulary 2008 Medica Group Advantage Solution Closed Formulary 2008 Employer Group Wrap addtions to the closed formulary View our formulary changes
Interested in mail order prescriptions?	Find a Pharmacy near you
Print the forms below to have your prescriptions filled by mail. Bio-Scrip mail order form Walgreens mail order form	Use our Pharmacy Directory to find convenient pharmacies in the Medica network. Medica contracts with over 56,000 pharmacies nationwide that equal or exceed CMS requirements.

Medica covers drugs from an out-of-network pharmacy only under special circumstances including illness while traveling outside of the plan’s service area where there is no network pharmacy. You may incur additional cost for drugs received at an out-of-network pharmacy.

Part D Transition of Care Policy

Questions regarding Part D Formularies? Contact Us!

Question about a coverage determination (exception), appeal or grievance?



CMS File #H2409, H2410, G2450, H2458, H7526_1427 (10/2007)

This information is current as of 10/05/2007