Medica's Medicare Formularies

A formulary is a list of drugs a health plan makes available to its members. Medica offers comprehensive formularies to help our members maximize their prescription drug benefit. There are two main types of formularies, based on the Part D plan you are enrolled in:

• Open Formulary - A formulary in which all Part D eligible medications are covered, but at various levels of cost sharing
• Closed Formulary - This formulary limits the number of eligible Part D medications within each therapeutic class for which a member will be reimbursed by the health plan

For a member to receive reimbursement for a prescribed drug, it must be on the formulary. Utilization management programs such as prior authorization, step therapy, and quantity limits apply to both types of formularies. Use the links below to view and print your plan's particular formulary information to compare coverage or to take to your doctor for discussion .

Medica's Medicare OPEN Formulary	Medica's Medicare CLOSED Formulary
Medicare Part D Plans that use the Comprehensive OPEN Formulary: • Medica Prime Solution • Medica Advantage Solution • Medica Complete Solution View 2009 Comprehensive OPEN Formulary. View 2010 Comprehensive OPEN Formulary. View Updates to the Current Comprehensive OPEN Formulary. Look up a drug on the Current Comprehensive OPEN Formulary: Look up for Prime Solution Members Look up for Advantage Solution Members Look up for Complete Solution Members	Medicare Part D Plans that use  the Comprehensive CLOSED Formulary: • Medica Advantage Solution Choice View 2009 Comprehensive CLOSED Formulary. View 2010 Comprehensive CLOSED Formulary. View Updates to the Current Comprehensive CLOSED Formulary. Medicare Part D Plans that use the Dual Eligibility CLOSED Formulary: • Medica AccessAbility Solution • Medica DUAL Solution View 2009 Dual Eligibility CLOSED Formulary. View 2010 Dual Eligibility CLOSED Formulary. View Current Dual Eligibility Over-the-Counter Drug List.

Are you looking for a Pharmacy near you? 
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 costs for drugs received at an out-of-network pharmacy. Search Pharmacy Directory.

Are you interested in Mail Order Prescriptions? 
Print the forms below and follow the directions to have your prescriptions filled by mail.
View Bio-Scrip Mail Order Form.
View Walgreens Mail Order Form.

Do you need extra help with Medicare Part D?
Find out if you qualify for extra help to pay for your prescription drug premiums and costs by contacting:

• 1-800-MEDICARE (1-800-633-4227) 24 hours a day, seven days a week. TTY/TDD users should call 1-877-486-2048;
• 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
• Your State Medicaid Office

Do you have a problem or complaint about your Part D coverage? 
View Medica Part D Problem and Complaint Resources.
View Part D Transition of Care Policy.

Do you want to talk to Customer Service about your Part D pharmacy coverage?  
Call Medica Center for Healthy Aging  952-992-2345 or 1-800-906-5432. TTY users may call the National Relay Service at 1-800-234-8819 and ask to be transferred to 1-800-906-5432. Hours of operation are 8 a.m. - 8 p.m. (Central Time), seven days a week. Please note that access to a representative may be limited evenings and weekends during certain times of the year.

H2410, H2450, H2458, 7526_2289 (XX-2009)
Content updated 10/01/2009 - pending CMS approval