Pharmacy benefits

For Medica Advantage Solution® H3632-001 (PPO) members

Check drug costs

Call us to get information on specific drugs available with your plan.

8 a.m. to 8 p.m. CT

Ways to fill your prescription

  • Mail Order

    Fill your prescriptions through the mail. You'll get a 90-day supply of your medication — with no shipping or handling fees.

  • 90-day Refill 

    Get up to a 90-day supply at one time from a participating retail pharmacy.

Prescription support

Extra help paying for your prescription (Low Income Subsidy)

Find out if you qualify for Extra Help paying for your prescription drug premiums and costs by contacting any of the organizations below. Click on your state Medicaid office to find contact information.

 

Medicare

Contact Information

1-800-MEDICARE
(1-800-633-4227)
TTY: 1-877-486-2048

Hours

24 hours a day, seven days a week

Social Security Administration

Contact Information

1-800-772-1213
TTY: 1-800-325-0778

Hours

Monday to Friday,
7 a.m. - 7 p.m. CT

State Medicaid Offices

Contact Information

Iowa
Nebraska

Hours

Note: Hours vary by state.

Best available evidence policy

If you think you qualify for the Low Income Subsidy but your current information doesn't reflect that, you can change your status on the Centers for Medicare & Medicaid (CMS) website.

Give your medications a checkup

If you qualify, our Medication Therapy Management (MTM) program provides one-on-one consultation with a pharmacist to manage your medications. Find out more about MTM here:

Pharmacy documents and coverage levels

Part D coverage levels
To see details for your Part D coverage level, choose your plan below:

Prescription claim forms

Need reimbursement for covered Part D prescription medications and vaccinations not submitted to your Part D coverage? Use the claim instructions and form below to get your prescription processed under your Part D coverage.

Drug list (formulary)

Part B Drugs

For members who are new to therapy, we may require step therapy on some drugs covered under Medicare Part B.


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Last Updated: December 2021
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