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Pharmacy benefits

For Medica Group Advantage Solutionâ„  (PPO) members

How to check drug costs

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

8 a.m. – 9 p.m. CT, Sunday – Saturday, 10/1 - 3/31
8 a.m. – 9 p.m. CT, Monday – Friday, 4/1 - 9/30

Ways to fill your prescription

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

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

State Medicaid Offices

To find out more about Medicaid and its programs, contact the Medicaid agency for your state.

Contact information

Minnesota
Wisconsin

Hours

Hours vary by state

Best Available Evidence (BAE) policy

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

About Best Available Evidence on CMS.gov


Give your medications a check-up

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

Learn more about the MTM program

Pharmacy documents + coverage levels

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.

Medicare Part D Prescription Claim Form (PDF)
Reimbursement Instructions for Prescription (Part D) Costs (PDF)

Drug list (formulary)

2023 Formulary (PDF)
2024 Formulary (PDF)


Part B drugs

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

View the list of Part B drugs that require step therapy


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Last updated: December 2023